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The Health Protesters
Twenty-three years ago, the World Health Organization's Alma Ata conference promised to deliver basic health care for all the world's population by the year 2000, under the clarion cry of 'Health for All'. Today, that promise remains unmet in too many countries and cities of the developing world where health is still the prerogative of wealthy elites - and the poor remain trapped in a vicious cycle of poverty and ill-health.
Frustrated by the failure of the international community to deliver on its promises of health care, doctors, health professionals and civil rights activists from around the world convened in Dhaka in December 2000 at the People's Health Assembly. Their mission - to draw up a charter of their own demands for health care, framed in a new and radical People's Health Charter. This third episode in City Life follows the process - from a 50,000 rally in Calcutta, through heated debates with World Bank spokespeople in Dhaka and argumentative late-night drafting sessions - to the final triumphant publication of the Charter on the final day of the Assembly.
This was not just a demonstration by thousands of poor people. Some of the big names in health were there - Dr Halfdan Mahler, who, as Director-General of WHO, was responsible for organising the 1978 meeting in Alma Ata and promoting the idea of 'Health for All'. "Why did it not happen?" he asks. And David Werner, the famous author of 'Where There is No Doctor', who explains: "Our big challenge is helping people to realise what are the forces, the world- wide forces, which are affecting our health and wellbeing today."
Geo Jose, of India's National Alliance of People's Movements, is bitter: "Not only health is not available to all the people but the mortality rate and ill health has increased day by day."
And today there's a new bogeyman: globalisation. Fifty thousand people turned out for India's National Health Assembly Rally in Calcutta, preparing for the Dhaka meeting. Delegates, local campaigners and school children brought one part of the city to standstill. Globalisation, free market economies and privatisation are all claimed as enemies of primary health care and, they say, the poor have been increasingly excluded form this New World Order, especially when it comes to medicine.
David Legge, of Australia's La Trobe University, says the greatest obscenity is the maternal mortality rate in poor countries. "Compared to Western countries where you get a handful of maternal deaths per hundred thousand live births, in Third World countries you're getting up to ten per cent of women dying in childbirth."
At the Assembly itself, there were outspoken attacks on the World Bank. The World Bank provides four times as much aid for health care as the World Health Organisation but its critics claim two billion dollars a year of this benefits the rich West rather than meeting the primary health care needs of the poor in developing countries.
Regional Director Richard Lee Skolnik tried to tell them this just wasn't true, and told the delegates to concentrate on what they could do best: "I believe the People's Health Assembly must help empower communities and people to improve water and sanitation, nutrition which is so often forgotten, hygiene which isn't anywhere on the agenda, and health seeking behaviours. . . I hope the People's Health Assembly will lobby governments to stop wasteful expenditure on war, on subsidies for the better-off and on corruption."
The World Bank now prioritises healthcare and education in development aid but that wasn't the perception at the People's Health Assembly. Many delegates still believe World Bank aid means scrapping national health schemes.
In fact, what the World Bank was saying was in line with what most of the delegates wanted. But the World Bank was thought to be part of the current global trading regime, which, according to David Legge, "bears many factors which discriminate against poor countries". And as Dr Debbie Daniels of Doctors for Global Health put it: "What really should be happening is that governments should be providing basic needs - providing for the basic needs of their community, including health, including clean water and a place to live and food."
At the end of the Assembly, they argued over the text of the charter - word by word, line by line - the charter which they saw as their chance to change the world health agenda. Halfdan Mahler asked: "Are we now, contrary to what happened after Alma Ata, going to take our challenge more seriously?"
Conference Convenor Dr Nadine Gasman saw it as a beginning, not an end: "I feel hope. I don't feel fulfilled -I think it's the beginning and that we have a big challenge ahead."
And the last word went to veteran doctor David Werner: "We need a popular revolution on a world-wide basis to oppose the élite powers that are endangering, not only the health of humanity, but the very future existence of humanity."
TRANSCRIPT
Read the full transcript of The Health Protesters
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