July 28, 2005
What is Utopia for, anyway?
Back from Ecuador, I have a certain frustration at so many things left unwritten and unsaid in these dispatches...but these notes were far from my primary purpose there, so what's said is said. I would've liked to tell more about the political situation there in Absurdistan, especially as several of the people I spent time with were involved in chasing out the President last April. I would've liked to tell what I know about a huge new US military base being built in the Amazon, to further enforce Plan Colombia and further dominate. I would've liked to describe the commercials I heard on the radio advertising the benefits of the upcoming Free Trade Agreement: "Ecuador is not an island -- Competition is growth, growth is development, development is progress." I would've liked to transcribe interviews I conducted with Adolfo Maldonado and Alexandra Almeira of Accion Ecologica, with Dr. Miguel Sebastian who has studied and continues to study the rates of cancer in the Amazon, with Camilo Santi of the Kichwa village of Sarayacu who are resisting petroleum development at all costs, and with Edgar Isch, the former Minister of the Environment who quit because of the recent government's neoliberal policies and corrupt practices. I wish I could describe what I heard of the Haourani people -- the least developed and most fiercely independent of Ecuador's indigenous groups -- who, the week before I arrived had planted themselves in front of the Environmental Ministry with spears and blowguns and declared war on any oil company that invades their territory. And I would have liked to offer more complete passages about how the People's Health Assembly works, how decisions are made, who is involved, and so forth.
But no time for all that. For those of you in the Bay Area, a few weeks from now you can expect to hear about a few reportbacks by myself and my colleagues at Hesperian Foundation, and our friends from the International Indian Treaty Council and the People's Grocery. Beyond that, I'll leave off with a quote from Eduardo Galeano, regarding all of this:
"Utopia is like the horizon. You walk two steps, and it retreats two steps. You walk ten steps and it retreats ten steps.
So, then what is utopia for? For that -- to make you keep walking."
Hasta la proxima.....
Posted by at 04:36 PM | Comments (0)
July 27, 2005
Closing days…
Major organizational challenges and difficulties in transportation have caused some discontent among participants in the People’s Health Assembly. There were 5 or more venues of events and no centralized transport to get people to events. The wealthier people from Europe and the US had no problem taking taxis – $1 USD to cross town 2 or 3 times a day; but those from Asia and Africa were often forced to walk, causing them to miss many events. And people with disabilities, of course, had it even worse, because many of the events were inaccessible. Sad to say, none of this is terribly surprising, and it reveals how much further we need to go to create equitable systems that can truly confront the structural inequalities. Even with the best of intentions, the organizers of the Assembly – health activists from NGO’s worldwide – were unable to create a system that would meet the needs of those most in need.
Fortunately these issues have been taken into account, and the organizers have committed to doing better for the next meeting, expected to take place in Africa in a few years. In any case, by the last days of the People’s Health Assembly, many of the 1500 or so people present had crossed paths a few times and something of a community feeling emerged, despite the challenges. Outside of every venue informal groups gathered where one could easily join a conversation with people from Nigeria, Peru, Puerto Rico, Bangladesh, Switzerland and Argentina – and as in any event of this size, it is these informal meetings that, perhaps, have the most lasting impact on people’s lives and work when they go home. For my part, because I had been widely sharing the new Hesperian Foundation publications on water and sanitation – which we are obligated to distribute for free – I was fortunate to meet dozens of the people who will use these materials in their home communities. Many of them shared stories of their work with me, and expressed deep appreciation for the solidarity and support shown by those of us from the North who are able to do this work.
One young man from deep in the jungle in Peru especially struck me. Jeiser Suarez, an indigenous Shipibo man from near Iquitos, on the Peruvian Amazon, works tirelessly to maintain his culture’s traditions, to ensure that garbage and contamination are minimized, and to preserve the jungle ecosystem where he lives. Jeiser traveled 6 hours by canoe and 5 days by bus to get to the health assembly because he felt that meeting other people doing similar work would strengthen his resolve and his abilities and because, as he said very clearly, “My culture is in danger and we need allies.” After we had talked for some time, in one of the most affecting moments of the week, Jeiser gave me a gift – a necklace of Guayruro beads (red and black beans that grow along jungle waterways) bearing a crocodile tooth that his own grandfather had taken from an animal he’d hunted years ago. The beads are for protection, he explained, and the crocodile tooth for bravery.
Jeiser Suarez with friends
Anyone interested in learning more about the Shipibo might want to begin with the website that Jeiser told me about: www.shipibo.com
The final day and the Cuenca Declaration
At the end of each People’s Health Assembly a declaration is drafted that promises action on many of the themes that have been discussed during the meetings. In this case, the document is called The Cuenca Declaration; a draft of it was read to the entire assembly on Friday morning, with many breaks for applause and a time set aside after for comments. Because the Declaration is still in draft form, I cannot include any of it here, but those interested might check the People’s health Movement website (www.phmovement.org) in a few weeks.
A document that contains similar information, summing up many of the issues dealth with by PHM, is called Global Health Watch: an alternative health report, and was released at the gathering. I’m not sure whether or not the document is available on the web, but to give an idea of the kind of stands taken by PHM, here is the introduction to the report:
Origins
The Global Health Watch comes out of one of the largest ever civil society
mobilizations in health. Its roots lie in the influential and lasting campaigns
of the 1970s and 1980s when activists across the world challenged the global
health divide between North and South and rich and poor. They formulated
practical proposals for change and influenced the content of the ground-breaking
1978 Alma Ata Declaration. Community-based health care, the essential
drugs list and controls on the marketing of infant formula are just some of
the results of this advocacy, which has changed the lives of millions of people
for the better.
During the 1990s, many activists came together again to take up more of
the continually emerging challenges in global health – and to tackle some of
the most intransigent ones such as poverty and inequality. A People’s Health
Assembly, held in Savar, Bangladesh, in December 2000, was the first step towards
launching a global social movement to attain the aim written into the
Constitution of the World Health Organization (WHO): ‘the enjoyment of the
highest attainable standard of health is one of the fundamental rights of every
human being without distinction of race, religion, political belief, economic
or social condition’.
Some 1500 people from 75 nations attended the People’s Health Assembly
and collectively drew up and endorsed a People’s Health Charter. The Charter
is a call for action on the root causes of ill-health and many people’s lack of
access to essential health care, and set the agenda for the People’s Health
Movement that emerged out of the Assembly.
This first edition of the Global Health Watch takes up the Charter’s call for
action and suggests ways in which the global movement of people concerned
with health can take its principles forward. In the process, it has brought together
health activists, health professionals and academics from around the
world to put together an alternative world health report. It is aimed primarily
at all those around the world who work in health care or for health and who
represent an important section of civil society. They usually have a certain
standing in society that enables them to be influential in promoting action
on global health.
But aren’t there enough world health and development reports already? The
World Health Report, produced by the WHO; the Human Development Report
compiled by the United Nations Development Programme; an annual report
produced by UNAIDS; the annual State of the World’s Children produced by
UNICEF; and the World Development Report issued by the World Bank every
year. The Global Health Watch is different, however. The paragraphs below
outline how and why health workers from all over the world have expressed a
need for such a report.
The politics of health
The co-existence of wealth and widespread, severe poverty suggests that the
latter can be avoided. The cost of achieving and maintaining universal access
to basic education, basic health care, adequate food, and safe water and sanitation
for all has been estimated at less than 4% of the combined wealth of the
225 richest people in the world (UNDP 1998: 30). In many countries in which
hunger is prevalent, there is enough productive land to feed their populations
many times over. Alternative social, political and economic arrangements at a
national and global level could change this stark reality.
The Watch therefore sets out an explicitly political understanding of the
current state of health around the world. This is nothing new – public health
has been recognized as a political concern for many years. As the famous
nineteenth century German pathologist, Rudolf Virchow, explained, ‘medicine
is a social science, and politics is nothing more than medicine practised on
a larger stage’.
UNICEF has devised a conceptual model for explaining child morbidity
and mortality. It states that, amongst other factors, the political, social and
economic systems that determine how resources are used and controlled need
to be considered so as to determine the number and distribution of children
who do not have sufficient access to food, child care, clean water, sanitation
and health services .
The UNICEF model is applicable to other aspects of health (for example,
AIDS and maternal health) and echoes the analytical approach used by the
Watch to highlight how the distribution of power, political influence and economic
resources shapes the pattern of health globally.
Poverty and development as a public health issue
Poverty is the biggest epidemic that the global public health community
faces. It underlies most cases of under-nutrition, fuels the spread of many
diseases and deepens vulnerability to the effects of illness and trauma. Poor
countries are unable to give their health and social services adequate resources, resulting in a poverty of health systems that compounds poverty at the
household and community levels.
The challenge of improving global health is therefore inextricably linked
to the challenge of addressing widespread and growing poverty. According to
the official statistics of the World Bank, the number of very poor people has
increased by 10.4 percent between 1987 and 2001 to 2735 million – almost
half the world’s population (Chen and Ravallion 2004). Furthermore, there is
reason to believe that the World Bank’s methodology for measuring poverty is
flawed and underestimates the true breadth and depth of poverty worldwide
(Reddy and Pogge 2006). The extent of poverty demands that tackling it is at
the centre of health programmes and health policy analysis, and that understanding
its causes and engaging with the political and economic reforms is
essential to abolishing it.
Health workers engage with the health effects of illiteracy; the lack of access
to clean water and sanitation; hunger and food insecurity; the degradation of
the environment; and militarism and conflict. These public health issues highlight
the common challenges shared by health workers, teachers, engineers,
geographers, farmers and biologists, to name just a few professions in fulfilling
the universal right to health and dignity. The Watch aims to promote health
as a theme that can bring together different sectors of civil society around a
common agenda for human development and social justice.
Inequity
Increasing levels of poverty have been accompanied by growing inequality.
The income gap between the fifth of the world’s people living in the richest
countries and the fifth of the poorest was 74 to 1 in 1997, up from 60 to 1 in
1990, 30 to 1 in 1960, and 11 to 1 in 1913. The world’s 200 richest people more
than doubled their net worth in the four years to 1998 to more than $1 trillion.
The assets of the top three billionaires are worth more than the combined GNP
of all least developed countries and their 600 million people (UNDP 1999).
Although inequality is commonly described in terms of differences between
rich and poor countries, one fifth of the richest people in the world come from
developing countries (Navarro 2004). Similarly, poverty and widening disparities
are not confined to poor countries – inequalities have risen in wealthy
nations over the past two decades.
An ‘equity lens’ is important because political and economic institutions
are shaped in ways that can reinforce unfair advantages and widen socioeconomic
disparities. International trade rules and regulations are stacked in
favour of richer countries and multinational corporations; debt cancellation
is given at the whim of rich nation creditors rather than as a response to the
pressing needs of citizens of poorer countries. The conditionalities imposed
upon poor governments by the World Bank and International Monetary Fund
(IMF) are undemocratic and have included the privatization of public assets,
thereby undermining public education and health care systems, and eroding
social safety nets.
The Watch therefore emphasizes not just poverty, but also the relationship
between rich and poor, between the powerful and the marginalized. Improving
the situation of the world’s poor cannot be achieved through aid or charity
alone; profoundly unequal power relationships need to be tackled first and
foremost. Health professionals can influence many of the decisions that will
lead to a fairer distribution of wealth.
Human rights and responsibilities
Article 25.1 of the Universal Declaration of Human Rights states that ‘everyone
has the right to a standard of living adequate for the health of himself and
of his family, including food, clothing, housing and medical care and necessary
social services’. Article 12.1 of the International Covenant on Economic, Social
and Cultural Rights recognizes the ‘right of everyone to the enjoyment of the
highest attainable standard of physical and mental health’.
Such declarations are a reminder that human rights encompass more than
political and civil liberty human rights; they also incorporate social, economic
and cultural rights. Universal human rights are not limited to a vote, free speech
and freedom from oppression, but include a right to household food security,
essential health care and other requirements that underpin human dignity.
Human rights discourse is often centred on the duties of states and governments.
Violations committed against people by governments, under the
guise of officialdom and the law, or with the complicity of the state, are rightly
condemned because they not only deprive people of the objects of their rights
(such as food and essential health care), but also attack and subvert the very
notion of rights and justice. There is in addition an acceptance that governments
are in breach of their duty if they fail to ensure in a reasonable manner
the progressive realization of human rights through the use of resources under
their control. Governments that allow corruption and fraud, for example, or
inappropriate public expenditure on armaments when large sections of the
population lack access to the basic means of survival and dignity, are committing
human rights violations.
However, a moral conception of human rights implies that social, political
and economic institutions must also be held to account. This is enshrined
in Article 28 of the Universal Declaration of Human Rights, which states that
‘everyone is entitled to a social and international order in which the rights and
freedoms set forth in this Declaration can be fully realized’.
For example, while a legal right to adequate food is important, and while
governments are obliged to ensure the progressive realization of this right,
political and economic arrangements that determine how food is produced,
controlled and sold may be as important, if not more so, in determining
whether this right is fulfilled. Such arrangements might include historically
unjust patterns of land ownership; the control of food production systems
that leads to monopolies; the speculative hoarding of basic staple foods and
excessively high food prices; or the dumping of heavily subsidized produce
from rich countries onto poor ones in a way that decimates local agriculture
and subsistence economies.
These examples suggest that even if governments do all they can, social,
economic and political arrangements that keep people living below the poverty
line when there are reasonable alternative arrangements should be considered
violations of human rights, even if these arrangements are legal. This implies
obligations not just on governments but also upon citizens and non-government
actors to re-shape political and economic arrangements to ensure the
fulfilment of rights.
Given global integration, governments, corporate actors and civil society
have transnational duties and responsibilities towards the fulfilment of universal
human rights. At present, the emphasis in human rights discourse is on
the responsibilities of governments towards their own citizens. Transnational
responsibilities for the fulfilment of human rights tend to be limited to avoiding
or preventing direct violations of the civil liberties of citizens of another
country, or merely invoke a weak humanitarian response to help out with aid
and other forms of assistance. Economic cooperation with corrupt and undemocratic
governments is not considered a human rights transgression, nor
is the maintenance of trade rules that perpetuate or deepen severe poverty.
In sum, the Watch embodies a human rights perspective that emphasizes
social and economic rights; identifies political and economic institutions,
including the manner in which economic relationships are organized and
structured, as being beholden to human rights declarations; and calls for a
greater recognition of transnational responsibilities towards the fulfillment of
human rights.
Mobilizing civil society and holding institutions to account
In light of the evidence that social, political and economic arrangements
are failing to address the current state of ill-health, poverty and inequity adequately,
a stronger mobilization of civil society committed to the fulfilment of
human rights is needed. The Global Health Watch is explicitly linked to many
civil society struggles for health and justice. Many of the individuals, networks
and NGOs associated with this report participate in civil society mobilization,
lobbying efforts, policy advocacy and development work on the ground. The
Watch draws on their experiences and offers credible analysis to strengthen
their work.
Part of the aim of this alternative world health report, therefore, is to
present an analysis of the performance and effect of key institutions that have
a responsibility for promoting global health. Health and development reports
produced, for example, by the WHO, UNAIDS and the World Bank tend not to
include themselves in the analysis of factors that are promoting or negatively
impacting on health. The Watch hopes to fill this gap and provide another
means of strengthening civil society’s ability to engage with the determinants
of ill health.
Overview of the Global Health Watch
The report is divided into six sections. Part A looks at how political and
economic change at the global level influences people’s health and well-being
worldwide, noting how little control individuals have over these changes. It
points to solutions for redressing global imbalances and shows how few of the
promises made to developing countries in past years have been kept.
Part B carves out an agenda for the public sector’s role in health, with a
special focus on low- and middle-income countries. Its first chapter asserts that
the Primary Health Care Approach adopted by the world’s health ministers in
the late 1970s is still relevant today, but that the public sector role in health is
under threat, and that commercialization of health care has proceeded apace
in the last two decades to the detriment of health. It points to the limitations of
current efforts to address health priorities through selective health care interventions
and pro-poor targeting. The chapter argues for a greater commitment
to universal health care systems and for renewed investment in the public sector.
Subsequent chapters on medicines and gene technology take up the theme
of commercialization and suggest ways in which the public sector role can be
strengthened. Other chapters explore two controversial issues – health worker
migration in low-income countries that are short of health personnel; and the
political struggle over sexual and reproductive rights, including analysis of how
health care is connected to broader debates about poverty, politics and gender
injustice.
Part C tackles the needs of two particular groups of people whose rights
to health are frequently violated – Indigenous peoples and people with disabilities.
These chapters describe their struggles for rights and outline what is
needed to strengthen their claims on health and health care over the coming
years.
Part D returns to the broader picture of health. The Primary Health Care
Approach emphasized intersectoral action in health, recognizing that the determinants
of health often lie outside the health care sector. Five chapters on
education, war, environment, water and food security reveal the widespread
threats to health in a diverse range of areas and circumstances, but also point
to the potential for synergistic actions by governments and civil society actors
that could improve livelihoods in several dimensions.
Part E scrutinizes the conduct of global institutions such as WHO, UNICEF
and the World Bank, and assesses the international actions of richer nations
and big business. The analysis points to the need to redress imbalances of
power at the international level; for richer nations to fulfil their promises on
resource transfers to the developing world; for tighter regulation of powerful
multinationals; and for better management of international institutions.
Part F concludes the Global Health Watch by drawing all the chapters together
and making some general recommendations and possibilities for concerted
action by civil society organizations.
What readers of the Watch can do
A central aim of the Watch is to strengthen existing campaigns and social
movements by providing an alterative analysis of global health. The report also
includes a number of demands that we make of governments, UN agencies
and other actors. We hope that health professional associations and networks
will become a more prominent voice in existing campaigns and movements to
achieve a healthier and fairer world.
We encourage you to spread the word about the Watch widely. It is freely
available on the web and on CD from the three co-ordinating organizations:
People’s Health Movement, the Global Equity Gauge Alliance and Medact. To
comment on anything in this volume or make suggestions for the next Global
Health Watch in 2007–8, please contact any of the co-ordinating organizations
at ghw@hst.org.za.
Further information
People’s Health Movement (www.phmovement.org)
Global Equity Gauge Alliance (www.gega.org.za)
Medact (www.medact.org)
Before the journey home…
The day after the closing ceremony of the assembly, I was preparing to fly home when my old friend Rafael showed up and convinced me to stay on a few days to visit some projects and some interesting places…so I did. That same day we collected our Yaqui friend Angel Valencia, our Zapotec friend Saul Vicente and Francisco Mocoso, the President of Ecuador’s Condor Loma Foundation – a small NGO devoted to environmental and cultural preservation – and piled in a pick-up truck to visit some of Condor Loma’s conservation projects high in the Andes.
It’d been too long since I’d taken a fast, bumpy cold ride in the back of a pick-up through the Latin American countryside, and I felt entirely at home as we ascended out of the Cuenca valley to the central cordillera of the Andes. About an hour out of town we came to one of Condor Loma’s pilot projects – a small town where they’ve built open reservoirs to capture rainwater and mountain runoff to feed farm irrigation. We stopped to speak with a couple of campesinos who were drying beans and ended up staying for a quick drink of aguardiente to talk about their hopes for another rainwater reservoir. When we left, the friendly – and now just-ever-so-slightly-drunk – campesinos offered us some of their beans to plant, which all of us gladly accepted.
A healthy, meandering river high in the Andes
An Andean home
Continuing on, we entered a preserve where Francisco and others had been restoring vegetation to the hillsides using different methods, with the hope of seeking funds to do larger scale watershed protection projects throughout the Andes. The most interesting method we saw was one that Francisco himself had pioneered: he built worm bins across a gulley, from top to bottom, so that rainwater would collect worm guano as it flowed down the hill and fertilize the soil. Entire hillsides that had been barren were no green with brush thanks to this simple method.
Simple irrigation using a hollow log
As darkness fell we returned to Cuenca to see Angel off to the airport.
Angel Valencia
The next day Saul, Francisco, Raphael and I piled into Raphael’s ’78 Ford for the day-long drive to Banos, to get Saul to the airport and the rest of us to the final visit of my stay in Ecuador. That last day turned out to be the gem of my visit.
Descending from Banos towards the Amazon is the Pastaza River Valley, a deep and narrow canyon dropping thousands of feet and awash in green towering peaks, crashing white waterfalls, and incredible views of volcanoes both near and distant. Due to the rapid descent from cordillera to altiplano to cloudforest to primary rainforest – in a 15 minute drive you descend 2400 feet in altitude – this canyon is home to some of the greatest biodiversity on earth. The road, which follows along above the river, is a thin ribbon running between two of Ecuador’s most inaccessible protected areas – Parque Nacional Yanuncay and Parque Nacional Sangay. Rumors claim that Yanuncay is where the lost Inca treasure is buried, and numerous expeditions have literally vanished inside the remote territory. Parque Sangay, crowned by the snow capped volcano Sangay which erupts every 20 minutes, is equally inaccessible, and is claimed to be the home of 16 ancient pyramids known as the Temple of the Jaguar.
At the spot where the river is thinnest, we left the car behind and descended a path towards some waterfalls known to the public as the Paylon del Diablo – the Devil’s Pylon – but known by locals as Condor Pacha because of the stone figure of an earthly condor that rises out of the falls. Just below the falls a long rope-bridge crosses the river, and we crossed and were welcomed by Paul, the caretaker. This spot, with its view of the falls and its incredible flora, was until recently a tourist attraction visited by thousands of trash-throwing, flora-trampling, coca-cola drinking visitors. But as little as a year ago the owners of the place – an Israeli family – realized that it was too special to treat it this way and they hired Paul, an ecologist from Cuenca, to take charge. His first decision was to close it off to tourists and invite only scientists, environmentalists and students of traditional medicine to visit the part known as “El Otro Lado” – the other side. Ironically, I had visited the place as a tourist a few years back, but now I had the honor of being welcomed into the inner sanctum.
Paul lead us down the path to a fully-equipped cabin where we began to talk and talk and talk about the temples hidden deep in the jungle, about the 92 endemic species of orchids, about the ancient paths that ran through here connecting the Amazon and the Andes. How to educate people about places like this, how to begin with the simplest actions like preventing littering and continue until an understanding of watersheds and traditional cultures and the vaster questions of ecology were built. Paul and the others of Condor Loma made it clear that their mission was nothing less than to protect the entire Ecuadorian Amazon from destruction, and that they began here, at the falls of Condor Pacha because this river valley is the “umbilical cord of the Amazon.” Francisco cut in – “no, we’re not beginning here, we’re beginning up in the Andes – this is the halfway point. To protect the Amazon, you have to protect the Andes.”
After a few hours, as the sun had fallen and the intermittent rain of the cloudforest wetted our hair, we built a fire, and through the night we talked and planned and committed ourselves to continue educating, to continue pushing for human rights and protection of natural resources, to spend every waking moment raising consciousness – our own and that of others – about the work that needs to be done here and everywhere. Towards dawn, when the moon pushed through the thick jungle clouds, we ascended to a smaller waterfall, and, in the dark of night, darker for being jungle, bathed in the falls. Returning to the house, a few hours of sleep as the sun rose and then the long, dull journey home…
Andean town deep in a high valley
The mighty Mount Chimborazo
Posted by at 05:01 PM | Comments (1)
July 21, 2005
...and speaking of hope...
Sometimes the testimonies of everyone in the world sufering from the abuses of industrial capitalism overwhelms and exhausts. Last night a few of us organized a meeting -- an encuentro -- because several of our indigenous delegates from the US and Mexico and several local indigenous and non-indigenous folks wanted to show videos and share experiences. Humberto Chica, a Canari (the local indigenous group) man who runs an organic farm and guides tourists to the nearby ruins and national parks, has taken a liking to our delegation, and he set up a session at the Alliance Francaise. He and a friend began be showing a video about their watershed protection projects, in which we learned about the importance of the place to the ecology of Ecuador. Cuenca means watershed in Spanish, and 4 rivers have their headwaters in the mountains surrounding this valley: Rio Tomebamba, Rio Yanuncay, Rio Machangara, and Rio Tarqui. All four flow into the Rio Paute, which flows down into the Amazon basin, to eventulay join the Rio Pastaza, the Rio Bobonazo, and eventually the mighty Amazon itself. So, in a way, this Cuenca, this watershed, is among the most important in Latin America (as if there is anything like an unimportant watershed...).
After that video, Sherri showed Gold, Greed and Genocide, a great and horrific short documentary made by Pratap Chatterjee about the California Gold Rush and its impact on the California natives. I did simultaneous translation for the crowd, and I can tell you that its exhausting translating phrases like¨: "the government of Calfornia paid $5 each for the heads of the Indians," and "boys were sold into slavery for $60 dollars, girls for up to $400." The film generated a lot of interest, especially because, as I´ve seen before, most people outside the US (and inside) don´t realize that any native peoples are left in the US. In any case, the hope here is in the mercury education project being carried out by the Indian Treaty Council for which I co-wrote a manual through Hesperian Foundation. Sherri and others travel to reservations and rancherias around California educating about the toxic legac of the gold rush. After that film, Angel Valencia, our Yaqui friend, showed "Huicholes y Plaguicidas" a short doc about the horrors of pesticide poisoning. After the film, he spoke, and got extremely emotional, because this is so clearly the extermination of his people. "Why is the life of a white child more valuable than the life of a Yaqui child, or an Ecuadora child, or a Peruvian child? This canot go on!," Angel said, in tears. He insisted then on showing another film about native peoples and toxics, and the night grew heavier, with the room sinking into near despair.
Still, in a session earlier that day about deep ecology, the presenters offered a new paradigm for global health, which does offer hope if we can carry it forward. Doctor Julio Monsalvo of Argentina and Sandra Isable Payan of Colombia spoke beautifully about what they call "Primary Health Care for Ecosystems". What they are promoting is a model of human health which includes the greater ecosphere, and takes into account a model of "power with, not power over", feminine being, recognition of natural cycles and energy flows, a rejection of dualities like good/evil, sick/healthy, masculine/feminine, and so forth, and a recognition of the sacred nature of, well, nature. Julio specifically describes the six A´s that make up health: "agua, aire, alimento, abrigo, amor, y arte." That is, water, air, food, clothing and shelter, love, and art.
The session on primary health care for ecosystems continues today, and I will present a discussion on ecological sanitation, that most humble aspect of the paradigm of integrated environmental health. Hesperian´s booklet on sanitation will be presented, and I´m excietd to present it in the context of health and deep ecology. And its exciting to see how much real interest there is in the subject -- I can´t pull the books out of my bag without being surrounded by community health workers clamoring for their copy....
And finally, back to the horrors that surround us, a few photos of a performance revealing the perceptions of American imperialism:
Posted by at 07:39 AM | Comments (0)
July 20, 2005
The Right to Water and the Right to Health
In a session yesterday afternoon on Water as a Human Right, we heard from activists from Mexico and Bolivia about the global and local water struggles they have engaged in, and then Anil Naidoo and I announced the need for a UN Treaty on Water as a Human Right, and talked about the work that is going on to make this happen. A very heated and somewhat frustrating discussion ensued among the sixty or so participants. One of the key issues seems to be that people feel that a UN Treaty will not give us what we want, and we should not have to ASK for our rights. But of course, as we see our rights trampled everywhere in everyway, securing some limited safeguards such as this Treaty is a way to support grassroots struggle. And, as in any campaign, the process of building coalitions and moving towards a common goal, in itself, is an important part of bringing about change.
After the session we were asked to put together an article for the People´s Health Assembly newspaper that comes out at here everyday, so Anil and I, with the help of Sherri Norris and Angel Valencia of the International Indian Treaty Council, set ourselves up in a smoky, atmospheric little bar, and wrote this little news item about it:
PHM Should Join the Global Campaign for Right to Water Treaty
An international group of water activists today called upon the PHM to join a new initiative to secure the right to water in a UN treaty. Anil Naidoo from the Blue Planet Project in Canada represents the Friends of the Right to Water and is in Ecuador to join the PHM. Naidoo wants to engage the PHM in the campaign to demand such a Treaty. “The Right to Health and the Right to Water are indivisible. It makes a lot of sense for the Friends of the Right to Water and the People’s Health Movement to work together on this fundamental health and human rights campaign.”
Water is sacred and essential for life. Damage to our water sources means sickness and death for our communities. Whether it is contaminated by gold mining, oil drilling, pesticides, deforestation or other industrial activity, water contamination is a fundamental violation of our rights. This UN Treaty would hold both states and non-state parties accountable for such violations.
Our common right to water is also violated by the corporations that are stealing our water and selling it back to us. When the water of Cochabamba, Bolivia was taken over by Bechtel Corporation, prices rose dramatically. When Coca Cola built a bottling plant in Plachimada, India, robbing groundwater to make their cola, local farmers suffered severe health impacts. With stories like these increasing across the globe, a binding Treaty to protect water from exploitation is essential.
Indigenous communities and other land-based peoples are some of the most strongly affected by the infringement on water rights. “We know that our problem is similar to everyone’s,” says Angel Valencia of the Yaqui Nation of Sonora Mexico. “When our water is stolen and polluted, this is a violation of our rights.” A Water Treaty would support the struggle of the Yaqui people and other indigenous peoples worldwide in the preservation of culture, dignity, and health.
A UN Treaty will not give us clean water. But binding international law with built-in enforcement mechanisms can be a powerful tool to support grassroots struggles against the commodification, privatization and contamination of water. By including the demand for a Water Treaty in the Cuenca Declaration, and by creating a working group on the right to water, PHM can use its platform on health to ensure water for all.
This year is the start of the International Decade for Action “Water for Life”, and communities around the world desperately need access to safe, sufficient, affordable water. PHM has already drafted a declaration supporting the movement for a right to water (see www.righttowater.net). At PHA2, with representation from peoples worldwide, we are granted a unique opportunity to secure this fundamental collective right.
In fact, the People´s Health Movement is uniquely situated to move this kind of Treaty forward, because many people within the movement are involved in policy at different levels. Every year, the PHM steering committee attends the World Health Assembly in Geneva and each country representative lobbies his or her Minister of Health on the PHM platform. In this way, an common global agenda is pushed forward. At the same time, groups like the Indian Treaty Council, who represent Indigenous Peoples of the Americas at the United Nations, push for these policies there, and direct action oriented groups like the Treatment Action Campaign, the disability rights movement, and the anti-war movement, bring these agendas to the streets.
At this point in the dispatch, I might add again that there is so much going on, on so many levels, that the bits and pieces I am offering are a small view into the events. Another major theme of the last few days has been militarization and war, with an Iraqi doctor, Dr. Salam Ismael giving a grueling testimony of events there, along with testimonies from the war in the Congo, the fumigations of Plan Colombia, the health crisis in Chiapas, and so forth. Fortunately I missed the session and the depression it caused in hundreds of attendees. Speaking with Brahm Amadi about it this morning, we reenforced our notion -- and Brahm and People´s Grocery are a great example of this -- that while we must face the realities of our time, it is our job as activists to offer hope, to imagine alternatives, to struggle with dignity for a better future.
The poet Diane DiPrima has said "There is only one war -- the war against the imagination." All other wars partake of this central strategy of denying vision, denying creativity, denying hope. My personal hope for a gathering such as this one is that, alongside the gruesome news from all quarters of the world, our collective energies will emerge into yet more visions for a positive future and yet more creative strategies for change.
Posted by at 07:59 AM | Comments (0)
July 19, 2005
Press Release: People's Health Movement PHM - re-establish health and equitable
WORLD HEALTH ORGANISATION MUST PROTECT THE HEALTH OF THE IRAQI PEOPLE
“Violence against doctors by the US occupying forces has triggered a mass exodus of doctors from Iraq”
Cuenca, Ecuador, 18 July: Doctors attending the second People’s Health
Assembly testified that over 100 doctors have been killed in violence
against doctors and patients in Iraq during the past two years of US
occupation.
“In 2004 alone 71 medical professors have been killed or been
intimidated to leave the country. There is complete insecurity in Iraqi hospitals that has resulted in many casualties” said Dr. Salam Ismael, General Secretary, Doctors for Iraq.
“Thousands of doctors, many of them highly experienced have already left the country” he said. Doctors for Iraq is an independent association of medical professionals that was set up in October 2003.
PHA 2 is being held here from 17-22 July. PHA 2 is organized by the
People’s Health Movement, a global coalition of health workers, doctors, activists and people from various walks of life.
PHA 2 is proposing to the WHO to monitor the health situation in Iraq
independently. “WHO should set up a special commission for this purpose” said a spokes person for the People’s Health Movement. “The world needs to find out the truth about what is happening to the Iraqi people under US occupation” he said while addressing a press conference here today.
The Iraqi doctor gave a blow by blow account of targeted attack on
hospitals and doctors. For example, he said that earlier this year at
the Bakoba General Hospital, in the east of Iraq – the army entered and beat up one doctor and arrested another. When the doctors protested they were also beaten up. And in May this year US forces laid siege to a
hospital in Hadeeth, western Iraq on the suspicion that there were
insurgents hiding inside. They subsequently raided the hospital and
smashed medical equipment, killing one patient with random gunfire.
Targetting civilian population and medical facilities and personnel is a blatant violation of Geneva conventions. “This is a war crime of the
first order” Dr. Bert De Belder of International Action for Liberation, Belgium.
PHA 2 began with a symbolic ceremony of indigenous people here yesterday at the Parque Arqueológico Pumapungo (Pumapungo Archeological Park). The ceremony was attended by delegates from over 70 countries.
“PHA 2 is a leap forward from PHA-1” said Prof. Quasem Choudhury ,
Bangladesh. Prof. Choudhury was the co-ordinator of PHA-1 that was held in Bangladesh that was attended by people from over 70 countries. “PHA 2 is making connections between the health movements in Latin America to
the rest of the world” he said.
“Free Trade Agreements are the number enemy of public health today” said Dr. Eduardo Espinoza, El Salvador. “Asia can learn lessons from Latin America”, he said while referring to the disastrous impacts of unfair trade practices that has reversed the health indicators in many
countries.
“What Africans need is justice and not charity” said Ms. Mary Sandasi,
Zimbabwe addressing presspersons here today. She was referring to the
failure of the recently held G 8 summit in affectively dealing with the debt issue."
PHA 2 will be held over five days and includes dozens of workshops and
seminars on a variety of themes ranging from impact militarization on
health to the politics of aid in emergency and disaster situations.
Delegates include doctors and other health personnel together with trade union, environment and human rights activists
For media enquiries: +593 919 6 1712 / +593 9873 9376 / +593 9453
0115 / +593 9156 2935
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Free Trade Agreement = Death, Poverty, Misery
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Nature, God, Health and everything
Every morning two plenary sessions having to do with all aspects of health, and every afternoon, workshops and roundtables with the ultimate goal of forging campaigns around everything health related: food security, essential medicines, traditional healing, the human right to water and sanitation, environmental degradation, toxics, and so on and so forth. To give a sense of the tone of things, the first plenary session on Monday was opened by Hugo Blanco, a health activist from Peru. He opened with this:
“For good health, we need good food. For good food, we need sustainable agriculture. For sustainable agriculture, we need to preserve biodiversity and protect the natural world. Judeo-Christian monotheism situates God outside of – and over and above – the natural world. In order to preserve health on a global level, we need to come to a new understanding of nature that situates God as nature itself, and recognizes the human being as a steward, not a conqueror.”
Other talks in this same session covered the impacts of colonization on aboriginal health in Australia, the growing recognition of indigenous medical systems in Guatemala, and the growing use of complementary alternative medicine in Cuba. Dr Marta Perez Vinas from Cuba shared this:
“Until the 1990´s in Cuba, allopathic medicine was the norm, even though a sophisticated system of medicine existed thanks to the early blending of West African and indigenous cultures. The indigenous people were completely exterminated, but the Afro-Cuban medical system retained some of the knowledge. In the 1990´s, the state began to support natural and traditional medicine, drawing on these traditions as well as Chinese medicine, homeopathy, microdosis, osteopathy, massage, etcetera.”
Interestingly, acupuncture is quickly becoming the most widely used modality in Cuba, and is most commonly used for surgical anaesthesia.
Dr. Vinas closed with this call: “Indigenous communities must not only defend their traditional medicine, but they have the responsibility to teach the rest of us, to transform society and improve the health for all.”
This is one of the real undercurrents of the People´s Health Movement, and its growing respect for traditional medicines is sure to be one of the movement´s greatest strengths…
In the afternoon, a long workshop on extractive industries: the devastating impacts of oil drilling in Ecuador, Nigeria, and Nicaragua, and of mining in Ecuador, Honduras, Guatemala and the Phillippines. The study of oil impacts in the Amazon that I helped work on 4 years ago was presented by Accion Ecologica, with gruesome photos and shocking data: 57% of people living in the oil region of Ecuador have some form of cancer. The number for those living within 250 meters of an oil well is 65.7%. And 83% of people in the area have some kind of illness that is directly related to contamination. According to Dr. Adolfo Maldonado, who executed the study, five years after an oil well is opened, people within 1.5 miles of the operation are 5 times more likely to contract leukaemia. This, he tells us, is the same data that was found after the atomic bomb was dropped on Hiroshima.
After the sessions, finally the entire delegation that I am responsible for has arrived. Brahm Amadi of the People´s Grocery shows up to share a room with me and Angel Valencia, and Anil Naidoo, a Canadian and member of the Council of Canadians and Friends of the Right to Water, shows up as well. Anil and I will present a session on Water as a Human Right, issuing a call for the People´s Health Movement to take up this campaign that he and I and others at Hesperian Foundation have begun to move forward. To see the document that we are starting with, check this link:
www.righttowater.net.
After dinner Anil and Brahm and I go out to have a drink, Anil and I to plan our session for the next day, all of us to discuss our sessions and campaigns. A more focused, motivated, and good-spirited crew of fellow-travellers could not be found.
Posted by at 07:19 AM | Comments (0)
July 17, 2005
A note of warning: this blog will be written as a narrative of events from a personal perspective, possibly mixed with analysis, commentary, news releases from the PHM media team, etc…Which is to say, I´m not counting words, so expect me to ramble on..
Upon arrival…
Arriving in Quito, my traveling companion Pam and I are met by a friend of a friend named Rafael Campoverde, a Chilean artesano. Pam catches a flight onward to Cuenca, where the assembly will be, and Rafael loads my bags into his car to drive me to his home a few hours south for a brief visit before he’ll take me onward to Cuenca in another day. Rodrigo’s car is a blue 1978 Ford Granada, a big old American sedan. He tells me the car is named “El Blues Brother;” with the biggest car and the biggest V8 engine in Ecuador, he doesn’t have to be afraid of the crazy roads and the crazier drivers.
We race through Quito traffic and out through town after town sprawling across the high Andean plateau. The valley stretching from Quito south is known as the Avenida de Los Volcanes, after half a dozen still active snow-capped rumbling volcanoes that reach to 14,000 feet and dominate the horizon: Chimborazo, Pichincha, Las Altares, Cotopaxi, Tumburahua. As we drive and the sky shifts and darkness falls, Rafael tells me about his work doing environmental education with children – “because they are the only ones capable of learning anything” – and of his studies with Ecuador’s oldest shamans. My connection with him is through past work helping to buy and protect land for an indigenous Kichwa/Shuar community called Amazanga, where I’ve visited for a week at a time on a few occasions. Rafael works with Amazanga, but more importantly, he tells me, he is one of a handful – literally five or so individuals – who are studying the medicinal plant knowledge and the spiritual healing arts of the Secoya people, a now very small indigenous group in the Amazon. The Secoyas’ situation is dire, he says: they are, or were, a people renowned for their profound knowledge of the plants of the jungle, and their elaborate ceremonies and rituals – and all of this knowledge now rests with a few elders who are no longer respected by the rest. The oldest, the grand-shaman of the Secoyas, is between 115 and 130 years old. The others are in their 80’s and 90’s, and not long for this world. And the only people dedicated to learning from them are a handful of foreigners – Rafael, who is Chilean, an Austrian, a Gringo, and a few more. And the knowledge they gain, though important, can be superficial at best.
The younger Secoya all receive money and favors from the oil companies to sell their land, to remain passive, to buy alcohol. The culture is on the verge of extinction.
I ask Rafael, in his opinion, what can be done to revert the situation, to slow it down, to help. Nothing, he says. “Ya se termino la cosa:” it’s over.
It seems that every time I arrive in Ecuador, I am greeted by this kind of bad news.
Baños, where Rafael lives, is halfway between Quito and Cuenca, and at one of the earth’s incredible edges where the Eastern side of the Andes begins to spill down into the upper Amazon. The town, named after its hot springs that cascade from the side of a cliff, is in the shadow of the volcano Tumburahua, which erupted as recently as 2000, causing the entire town to be evacuated. Rafael takes me immediately to the baths, to recover from 12 hours of travel. Here, a massive pool of hot water coming straight out of the mountain sits below a waterfall hundreds of meters high. It is Friday night, and the place is “full” as they say in Ecuador: families, children, teenagers, everybody here splashing and laughing and enjoying the gift of the volcano. After a brief “relax”, as they say in Ecuador, we head to his house to talk and sleep. But before sleep, he leads me outside, when the night is quiet and says: “Listen…you can hear the volcano.” In the silence of the night from the mountain that rises directly behind his house and blocks the horizon, I hear a slight groaning and bubbling. The volcano is mixing its brew.
Day 2
We leave, by car, for Cuenca, six hours or so to the south. Beneath the majesty of the volcanoes and mountains encircling the horizon, the road from Quito to Baños is all urban sprawl, dirty towns of cement buildings and diesel fumes. In contrast, from Baños south to Cuenca we enter more rural terrain – indigenous villages of wattle and daub houses with thatch roofs interspersed with the more common cement block “missionary style” houses, and huge rolling, tumbling valleys patchworked with farmland: potatoes, onions, quinoa, wheat, barley. Women and children in typical Andean clothes tend sheep and cows along the roads and up in the hills. They wear brightly colored shawls, and Rafael tells me, laughing, that this is so that they can see each other from one mountainside to the next.
Our journey takes us high, over 12,000 foot passes and down into 8000 foot valleys, and up again through terrain both spectacular and brutal. Everywhere the mountains are almost completely without trees, aside from scattered patches of eucalyptus – an invasive weed planted for quick firewood but not even good for burning. Most of the patchwork of fields is bare and brown, and entire mountainsides are nothing but dead soil. At the height of our journey, through the desertified high sierra at 12,ooo feet, the pavement ends and along the dirt road we pass an old man, tiny with his back hunched and his hand held out to any passing vehicle. We stop and give him a dollar, and he blesses us. After this, every 200 meters we run across the same, only now they are children. Bands of children stretch a rope across the road to stop our car, and we stop, ask their names, and hand out tangerines and small coins. At one such roadblock I get out of the car and raise my camera to take a picture. The children all remove their hats and cover their faces. I put down the camera, and hand out more fruit and more coins. Looking around, there is nothing but hard-packed clay soil, rock, and small bands of children.
The whole way we are talking, madly, me asking questions about the political situation here, Rafael telling stories of the riots, of the past presidents, of the indigenous movement. “Every government lasts less time than the one before,” he says. “This is the only country,” he says, “where the politician, at the end of his term, packs suitcases full of cash and quietly slips out of the country, and the next one does the same.” “Cash, really,” I ask? “Si,” he says, “no one will give them a credit card.” En fin, he tells me that the common name for Ecuador is Absurdistan, and bursts into laughter.
Descending into Cuenca, we arrive at nightfall, and Rafael leaves me at my hotel, where – muy de repente – all the delegates to the People’s Health Assembly are checking in. We part, and suddenly I am cast into a mass of people from India, from the US, from all over the Americas. Hundreds of others from Europe, Asia and Africa are in hotels around the city. I am handed a program packed with more talks, workshops and cultural events than 1000 people can attend in a single week. It is clear that my slow arrival across the mountains is over and a great chaotic week is about to begin.
On Sunday, the welcome ceremony: an elaborate ceremony with music, dance, blessings of the four directions by curanderos from various cultures, 1000 participants dressed in white and traditional clothes, calling for a blessing of the week´s events and for unity of purpose, vision and a devotion to the earth. This sort of thing is better left undescribed, so that´s that. You had to be there.
Posted by at 07:51 PM | Comments (0)
July 06, 2005
The People's Health Assembly, Cuenca Ecuador
For starters...
This blog will be a record, a scattering of thoughts and impressions, from the People's Health Assembly, a gathering of activists from around the world in Cuenca, Ecuador, high in the Andes, between July 15 and July 23, 2005.
I've been to Ecuador twice before. My first visit, in 2000, combined several goals -- a research trip to visit community development projects on the Pacific Coast devastated by El Nino, a stay with a kichwa/shuar indigenous community in the Amazon -- called Amazanga -- to record some of their story and help them buy up land that once belonged to them, and an attempt to build a relationship with the radical environmental human rights group Accion Ecologica, for further research into the health impacts of oil drilling in the Amazon.
My second visit, in 2001, involved working with Accion Ecologica on a study of the health impacts of oil from Lago Agrio near the Colombian border south across the Rio Cononaca, deep into the jungle. It was one of the most miserably depressing experiences I've ever had. We interviewed hundreds of people living in the area -- about a third of whom were cancer victims, took photos and videos, and laid the groundwork for a study which was published by Accion Ecologica two years later.
An article I wrote about this visit can be found here: http://www.newtopiamagazine.net/archives/content/issue17/features/ecuador.php
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So, somewhat familiar with the terrain in Ecuador -- though that terrain is always shifting in the country's perpetual economic and social crisis -- I'll be landing there for a whirlwind week, attending the People's Health Assembly. There, I will present on a few panels about environmental health and justice, I will collect audio footage for a radio show on oil, and I will listen to the testimonies of people from around the world who are working to change the deteriorating conditions of health everywhere...
For an introduction to the People's Health Movement and the People's Health Assembly, read on....
How it all started
In the beginning, there were thousands of people across the world working very hard in big and little ways to promote the dream of a world where a healthy life is a reality for all. In the optimistic, joyous, compassionate 1970’s it seemed that this would be possible. And was not the Alma Ata Declaration signed by 134 governments in 1978? Did not the declaration promise Health For All by 2000? When the millennium edged closer and equitable health policy was still nowhere the optimists did not give up. They knew that the Third World had been plunged into debt and health care was in danger of complete privatization. To remind the world of the commitment made in more hopeful times the optimists came together in solidarity.
When the optimists met
People's organizations, civil society organizations, NGOs, social activists, health professionals, academics and researchers came together to make a strong statement against the studied indifference in this crucial area of human life. The First People's Health Assembly was organized in Savar, Bangladesh in December 2000 to discuss the Health for All Challenge. The 5 day meet led to sharing of experiences from across the globe.
The assembly in a single voice condemned the international institutions, multinational corporations and governments which are willingly pursuing anti-people policies. The multi-national corporations who push for policies which put profits before people and the proponents of liberalisation who recommend that governments should cut expenditure on social sector like health and education came in for scathing criticism. In all 1453 participants from 75 countries came together to create and endorse a consensus document called the People's Charter for Health. The charter reflects the vision, goals, principles and calls for action that unite all the members of the PHM coalition It is most widely endorsed consensus document on health since the Alma Ata Declaration
The Movement: From Savar to Cuenca
The participants of the assembly took strength from each other and reiterated their goal to seek more compassionate and equitable health policy. The time for lonely battles was over because the threats were global and it was only a question of who went under first. Since Savar, the People’s Health Assembly knit into a movement of over 80 nations across the world, sharing energy, knowledge and resources. Affirming the goals of that first meeting, the Second People’s Health Assembly will meet in July 2005 in Cuenca, Ecuador.
The Process
The Assembly will be the result of a process of local and national reflection, discussion, debate and exchange of experiences of communities and networks as well as conferences and workshops about the aspects that influence the health and well being of everyone. And the optimists will ask the voices of the earth to demand “Health for All Now!”
The Right to Water and Healthy Sanitation
Among other topics, a focus of my work at the People's Health Assembly will be on sharing eudcational materials on basic issues of water and sanitation that I have co-created at the Hesperian Foundation. As part of ongoing work to produce A Community Guide to Environmental Health, two booklets, one on water security and one on healthy sanitation options -- both focused on communities in the developing world -- have recently been completed in collaboration with the United Nations Developement Program, and I will present them with many of our grassroots partners in Cuenca.
The booklet on water is not on the web yet, sad to say, but the booklet on sanitation -- and who doesn't love sanitation? -- is here: http://www.hesperian.org/pdf_files/Sanitation.pdf
Perhaps more politically thrilling than ecological toilets is the not-unrelated issue of water, and the ongoing struggle for a human right to water. As part of my work with Hesperian and the People's Health Movement, I have helped to draft and publicize a statement demanding that the UN pass a convention declaring safe, sufficient water to be a basic human right.
In Cuenca I'll meet with groups working internationally to promote this right, and those at the forefront of the struggles in Bolivia, Mexico, Canada and elsewhere. As most of us know by now, the struggle to maintain our right to water as a common good is one of the burning issues of the current moment....
The statement demanding a human right to water is here: http://www.righttowater.net
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