What holds us together in the struggle for health
What are the “forces” that keep people together in movements, and particularly in PHM? This aspect is related with the identity of the movement and lies at the core of its vision for change. It is also tightly connected to the idea of health as wellbeing, and with the fact that health activism should – in the first place – make activists feel better!
A health movement is made of people who get together to achieve a health justice goal they care about. In most cases, people explicitly discuss a strategic plan and what their programme will be to accomplish their goals, in order to decide how to organise themselves and how to act within the group/movement. However, what really holds people together are probably underlying “forces” like relationships, bonds, emotional connections, and the sharing of values and feelings. With whom we are connected, how we are connected, and how well we feel in these connections are important for the “health” of the movement and for its continuity over time.
Relationships and values
Our relationships are nourished by sharing common values. In PHM, for example, we believe that health is a human right. We should act in solidarity to promote the right to health and to fight inequalities and the forces that create them.
Through endorsing the People’s Charter for Health, PHM members commmit to:
promote Health for All through an equitable, participatory and inter-sectoral movement and as a Rights Issue
advocate for government and other health agencies to ensure universal access to quality health care, education and social services according to people’s needs and not their ability to pay
promote the participation of people and people’s organisations in the formulation, implementation and evaluation of all health and social policies and programmes
promote health along with equity and sustainable development as top priorities in local, national and international policymaking
encourage people to develop their own solutions to local health problems
hold local authorities, national governments, international organisations and corporations accountable.
Through solidarity we care about each other and are ready for mutual support. In the story of PHM Kenya, the group initially spent a lot of time trying to decide on organizational matters (such as means of communication, office bearers, criteria for membership, etc.). Without resolving many of these issues, the group ended up gradually building connections among its members. These connections proved to be key when they later worked to resolve internal disagreements that arose in relation to managing a collective property (assets obtained through a grant).
PHM in Argentina teaches us that, in order to care for and maintain relationships, small groups work better than large groups. They speak about a “human scale” that shows that smaller groups, especially those that are closer to the daily life of their members, allow for higher levels of engagement and deeper mutual knowledge and affection.
Explicitly addressing the importance of sharing a set of values, such as solidarity, can be very relevant, particularly when we have to decide with whom we will partner in our movement. In some PHM networks this exercise has been a founding step.
Values and respecting diversity
The idea that we should preferably partner with individuals and groups that share our values does not mean that we need to all think in the same way. On the contrary, many PHM groups and networks across the world value diversity of visions, backgrounds, and experiences. In the experience of PHM Kenya, it has been most important to have a core group of committed members and to also encourage diversity among the membership, bringing different skills, perspectives, and resources.
However, we need to understand that difference is enriching and then commit to it, because working across diversity needs the capacity to accept that our own vision is not “the only” or “the right” one. In the popular health movement Laicrimpo Salud in Argentina, for example, they believe that all participants are equally important:
“we are all protagonists, we all know, we all do, we do not depend”.
The experience of PHM Scotland demonstrates that local PHMs need “a range of perspectives […] with a willingness to adapt to one another’s perspective” in their steering groups. Involving both academics and health/community practitioners, united by a “passion for improved population health”, PHM Scotland led a very successful participatory action research initiative and developed a People’s Health Manifesto that’s now being used for advocacy at the political level. This was possible because “those who have become active in PHM Scotland have often adapted their pattern of work”, and “those involved in the steering group had their thinking challenged and stretched by the encounter with people with similar values but with very different perspective and experience”.
PHM Kenya advises to plan in advance on how to handle conflicts among members before they happen and to be sure that all value solidarity so that the movement does not suffer.
Relationships with “life as a whole”
Relationships can be not only among people but include links with nature (land, plants, animals), the Earth, and the transcendent (the spiritual/immaterial world, the ancestors). In the vision of many Indigenous people, for example in Latin America, to speak about health is to speak about the wellbeing of all this and the balance between all the elements. For example, in the city of Porto Alegre a public health intervention was successful in mobilising (with) the community because it started off by recognising the spiritual roots of the link between water and life (referring to “the divinity of water”). This recognition, backed by good will and honest collaboration, helped to build trust and mutual understanding, which were key for the success of the project. As a result, the marginalised community became more and more able to assert its rights.
Wellbeing and pleasure in doing things together
As activists in a health movement, we should (also) care about our own health! In many cases, however, we seem to struggle with balancing activism and wellbeing: overcommitment, long tiring meetings, stressful travel, challenges of working with few resources and great ambitions, managing conflict, and so on. Some PHM groups have decided to place the wellbeing generated by participating in activism at the centre.
Since family relations are meaningful for everyone, in the meetings of the Jarilla network in Argentina participants bring their children, and there’s a dedicated space for them in the activities. Moreover, they pay attention to aspects such as the setting of the meeting (in beautiful, natural spaces), preparing and eating meals together, and including dance and music as these are considered important aspects of “being well, together”. This is particularly important in the Jarilla network because they believe that if people participate out of pleasure, they will feel free, and the positive feelings will be regenerated for the benefit of all.
Some groups, such as the popular health movement Laicrimpo Salud, explain this using the concept of “alegremia”, the happiness that flows through our bodies – a key determinant of our health!
PHM in India also values this “immaterial” contribution that’s generated when people share something. In the mobilisation that led to the first People’s Health Assembly and the creation of PHM in India, new partners shared dimensions beyond knowledge, skills, and finances. They
“brought new confidence and new optimism. Groups working in the field or in isolation experienced the warmth of peer recognition of their work from others working for the same cause.”.
1The Jarilla network originally spoke of “medicinal plants” as there was an interest, particularly from health workers, to know more about their active principles. With time, people realised that there are many plants that do not only heal, but help to stay healthy, besides making people happier through their presence and beauty. In the words of a Jarilla network member: “We share with the plants a time and a space in our home, the Earth, and we complement each other together with all the other beings. Speaking about “medicinal plants” conveys a utilitarian vision that we do not want. We prefer to call them ‘plants for health’”.