Monday, August 08, 2005

Taking stock

July 22nd:

Before setting out Friday morning, I packed my bags – Jael and I planned to set off at 1.30 pm. Today, there was just one plenary and we had been warned to arrive early to ensure seating and availability of headsets. The final day of the assembly started off with a parade of nations, with representatives from all countries invited onto the stage. Next, Qasem Choudhury, the convenor of the first Public Health Assembly spoke about the assembly in Bangladesh in 2000.

Then Ravi Narayan tok the stage. He spoke of the strengths and challenges that face PHM. An independent audit a year ago had yielded praise - 'PHM is a celebration of diversity.' and a 'young and growing movement'. The charter had been translated into over 50 languages and has benefited from the involvement of communities across the world. It has presence at local, national and international for a through networking and coalition buiding. A world health report – 'Global Health Watch' had been prepared and released. The weaknesses of the movement are that linkages to communities are not yet good and many areas of the globe have still not been reached. And of course, the blight of almost all movements – inadequate documentation. The language barriers have also been an impediment for achieving better documentation.

Of course, there is no dearth of opportunities: more links needed to be established with wider social movements and campaigns. Enthusiasm had to be generated among young health activists and the socially excluded – indigenous peoples, the disabled or differently abled and other groups. Ravi challenged the audience to have 50 % attendees under the age of thirty and/or from marginalized communities at the center of the next assembly. Oh geez, I'm old :(

Some of the question/challenges posed to the audience: is PHM too event- and publication-oriented? Has it done a good job in emphasizing social and political determinants of health? Does PHM make a difference in people's lives? Is it 'for the people' or 'by the people', i.e. is there true grassroots representation? Ravi remarked that this time more campaigns and movements were present (last time it was on a more individual basis), so a lot more people have been represented. But is PHM truly inclusive? A big dilemma for the movement is the balance between supporting local struggles and coordinating global actions. Local as well as policy-level changes have to be made to make a sustainable change.

The audience was then invited to make brief comments. One person mentioned how essential reports on environmental degradation was for the Global Health Watch report (which was released on Wednesday). Others comented that future PHA's should be held in grassroots communities rather than spread out in a city and should have less presentations and more songs and dances. A Canari man (indigenous, from near Cuenca) declared that this historic experience should not only remain only in our eyes and on paper. It should be translated and acted in all the countries of the world with a fraternal hug. A delegate from Africa commented on brain drain and its challenges to health care.

Ravi responded briefly to these comments. He said people have gotten quite carried away with Powerpoint presentations and this will not happen next time around (wonder what gizmo it will be then!). He also said that the choice of venue (which hasn't been very popular for conference purposes – the town is gorgeous though) had been made by the Ecuadorian delegation and reflects that PHM is everywhere – in villages, cities and grassroots communities and now in universities as well.

Next were testimonies from invited delegates. Anita Ghai represented the disabled or 'differently abled' people. She reminded us that we were all only temporarily abled. The group demanded more accessability everywhere – they have had a hard time this week, with being carried around to having to crawl up stairs in some dire cases. 'Nothing for us without us', she declared. Delegates from Australia and Haiti mentioned how important the empathy and friendship created during this week were. In typical poetic style, the Haitian woman declared that 'heaven had descended on all of us'.

Fatima from Bangladesh talked at length about Gono Shastro Kendra – about how it had created a pharmaceutical industry which employs women and supplies essential medicines. It influenced the National drug policy, the Labor movement and the status of women.

GSK were at the forefront of forming PHM and their work in Bangladesh is amazing

Lilian, a 13 year-old from Tanzania, delivered a simple message: 'We'll build a strong PHM in Africa'. Finally, a message from Director-General of WHO, Dr. Lee, was delivered to the audience via DVD. Among the various achievements he touted was a Treaty in opposition to harmful industries framed this year. He also lauded PHM's achievements.

It was time for an intermission and I stepped out to find Prasanna and Vineeta outside. After all these days, it was the first time the 3 of us were in the same place at the same time. We decided to skip the next presentation, which was the reading of the Cuenca declaration and discuss AID strategy instead. There have been a lot of misconceptions within us and this was a good opportunity to clear the air. I took the role of clarifying what AID-US is, what it can and cannot do legally and what it could strive to do operationally. The crux of the matter was the role AID-US can play in PHM-US – how much can we get involved in issues of interest in the US. We came to the conclusion that we can actively participate in decisions made in the US that directly impact India, such as the protest against the Patents Act, the anti-Dow campaign etc. The picture is less clear in the case of denial of healthcare within the US, environmental degradation etc. But plenty of AIDers have been engaged in such actions in an individual capacity and we could do that in the case of PHM-US as well. We decided to start on an educational module about PHM and Primary Health Care within chapters in the US.

Prasanna has a number of other thoughts he'd like chapters in US to internalize – thekind of projects we support and the expectations we have from them. I think he hopes that he can promote this through the Health issue. So the right to Health is not just a mobilizing but also an educational tool!

We left the venue to go to lunch and hopefully to meet Sarah and Tawnia there. But it was getting late for me, so I left to meet Jael and head out for the next part of my trip.

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