Food to confront a submissive thought
1. Power is to be understood here as the submission of some to the will of others. When power leads to the advancement of an individual’s or a minority group’s own interest, it becomes linked to exploitation and thus to the violation of human rights (HR).
2. Duty bearers manage or control ‘authoritative resources’ that result (flow) from the established and given organization and distribution of power in a given society.
3. Existing structures and institutions embody relationships of power; they are the manifestation and materialization of power. Furthermore, social and political organizations are designed specifically to distribute power in a given way. (Note that organizational charts represent relationships of power!).
4. In HR work, we are called to uncover the structural determinants of people’s-condition-of-oppression so as to help them transcend these conditions; this means increasing their bargaining power and aiming at their emancipation. (This is the only sensible way out since the existing social system and class relationships, embodying key human relations of power, do constraint people’s actions).
5. Emancipation takes place whenever people are able to overcome past and present restrictions (and overcome their rights being violated). In a way, to emancipate means to invert the poles. For this to happen, there is no need for more money; people just have to impose fairer rules.
6. We, therefore, need to assert ourselves against the current powers of control and find and create such a fairer balance. (J. K. Galbraith)
7. It behooves HR activists to identify the political distortions being used by the (minority) power holders and to uncover how these distortions (often disguised in a whole new jargon or "newspeak") result in oppressive and exploitative power relations.
8. Power can be, and often is, socially malign; it is linked to conflicts of interest...and counter-power is the means by which these (dialectical) conflicts are resolved.
9. Moreover, power is often hidden. For instance, solutions based on ‘compensatory power’ offer incentives and rewards; those based on ‘conditioned power’ change beliefs through persuasion and education. Only ‘coercive power’ wins submission by directly, more openly and more blatantly, violating people’s rights.
10. Resolving conflicts and balancing competing interests brought about by these three powers is the art of politics.
11. People’s participation in social networks can (and does) become a critical source of power; actually, these networks are to be seen, first and foremost, as the most viable vehicle to build people’s power. (Remember that ‘divided-we-beg, united-we-demand’...).
12. In the confrontation of networks against hierarchies, HR activists should use the art of politics to get involved in creating these social networks and helping them mobilize to effectively place their claims.
13. Whining about the North or the rich being too powerful long ago ceased to stir any pangs of conscience. The only chance to become a player, not a ball, in the game of eradicating HR violations is to try and build up countervailing clout. (F. Nuscheler)
14. But this clout cannot stay only at the level of protesting (e.g., at the WTO or the WB/IMF meetings); a newly acquired clout will only take us to higher levels if it makes viable, constructive (new) propositions...and in HR work we can make plenty those propositions: re-read your old HR Readers...
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Through much of this Reader I distilled arguments found in several issues of D+C the German development journal, the book ‘The Hidden Connections’, by Fritjof Capra, the book ‘Heading South, Looking North’ by Ariel Dorfman and the book ‘Refugiado del Iraq Milenario’ by Claudio Sepulveda.
Food for a charismatic thought
1. When reading the last three (or more) Readers, it becomes clear that the question of leadership is a crucial one for the human rights (HR) movement.
2. A leader is a person who is able to hold a vision, to
articulate it clearly and to communicate it with passion and charisma. S/he
creates conditions rather than giving a pre-conceived direction; s/he uses the
power of authority to empower others, enabling and mobilizing communities,
giving sense to where they are going. S/he often accepts responsibility far
beyond what may be expected. Leaders do not design solutions, they analyze
situations, reflect them back, increase connectivity, amplify voices, recognize
opportunities, act with a purpose, make people feel they are supported, feel
free to make mistakes (learning is as good as success).
How many of these characteristics does anyone of us
have?
3. Because of so many past and present misdirected efforts, most NGOs no longer can be counted among the leaders in HR work. For the time being, funding NGOs is not the groundbreaking answer to the reduction of poverty - and less so to the eradication of HR violations.
4. No one doubts NGOs have good intentions, but it is no longer accepted without question that they actually do any good. So far, there is no evidence many of them are better than governments. They just do things differently. Their million dollar projects just ‘do not cut it’... It is a shame that NGOs are often better networked with the outside world than with their own hinterland. (R. Chambers)
5. A mass of mini and micro projects conducted by NGOs does little for the development of the countries they work in. It is thus high time they put their (original/initial?) ideals first. They need to embark in a frank internal political dialogue and a dialogue with beneficiaries (and decision-makers).
6. Without effective leadership, I see no prospect for governments developing an intrinsic commitment for the needed structural reforms unless they realize it is in their enlightened self-interest to do so. Nor do I overestimate the current power of civil society actors to make a difference and bring about change.
7. Here is the challenge, then, to become an effective leader and to influence thousands of others in our respective fields of work. Are we up to it?
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Through much of this Reader I distilled arguments found in several issues of D+C the German development journal, the book ‘The Hidden Connections’, by Fritjof Capra, the book ‘Heading South, Looking North’ by Ariel Dorfman and the book ‘Refugiado del Iraq Milenario’ by Claudio Sepulveda.
Food for a ½ healthy and ½ sick thought
Have you ever noticed that when we have a problem with something, we declare war on it? The war on illiteracy, the war on AIDS, the war on drugs, the war on human rights violations (?). We don’t actually do anything about it, ...but we’ve declared war on it. (George Carlin, comedian)1. It has been said that the world cannot remain ½ healthy and ½ sick and still maintain its economic, moral and spiritual equilibrium. (World Health Assembly President, T. Scheel, 1951)
2. Staying in the realm of the ½s, we also live under ½ democracy and ½ oligarchy - and, in HR work, it is our job to keep it from becoming all oligarchy lest we become pawns in the rich nation’s/corporations’/individuals’ chess game.
3. HR work will win the endorsement of the ruling class only after long struggles. Democracy does not work without citizen activism. Trickle down politics does not work much better than trickle down economics. HR happen because we do not leave things to other people. What’s good and right does not come naturally; we have to stand up and fight for it - as if the cause depended on us, because it does! So go for it; never mind the odds. (Bill Moyers)
4. Politicians and decision-makers do need intellectuals (HR activists?) to give them ideas and to reinforce (or actively oppose) their agendas. No political leadership can function without adequate intellectual support (and/or opposition) - no matter how spurious. And our ideas about the role of HR do have power - as long as we do not freeze them as dogma. So, no government must be automatically categorized as impossible to win over. HR-based alliances can and must be forged in our daily work. Only if this does not work, should HR work embark in de-legitimizing raw power.
5. Neo-liberalism fans the illusion that anyone, anywhere can
become a fully fledged capitalist. Actually, in the free-market-economy,
citizens become customers... and in reality, for essential services (and thus
for the fulfillment of most rights) prices function as the gatekeeper of access.
So, what is the meaning of competition if/when those whose rights are being
violated cannot win at all...? But the system trumpets its successes and only
whispers its failures, so we get to hear little about the latter. The bottom
line is that, under Globalization, there is no fair treatment or
competition-on-an-equal-footing both nationally and internationally.
[Come to think of it: Is there such a thing as Globalization
with equity...?].
6. Keep in mind that, over the past decade, 54 countries out of 194 have become poorer (...and that inflation is one of the cruelest and most regressive of all taxes). (See the IMF’s F+D reference below, p. 32). This is why this Reader keeps trumpeting that without poverty reduction strategies, millions of dollars spent on ‘development’ will do little lasting good.
7. Poverty reduction IS the main goal to achieve; not as an afterthought; not as a matter of secondary importance, but as a litmus test of the sustainability of our political choices. It is this test we have to pass. (Hilde Johnson, Minister of International Development, Norway)
8. For poverty reduction to happen, we know, growth is necessary, but not sufficient. In many countries though, persistent poverty is the result of persistent inequalities that prevent the poor from participating in the necessary growth to begin with. Pro-poor growth policies, therefore, have nothing to do with economic trickle-down hopes. They are policies biased in favor of the poor - policies that enable them to benefit proportionately more than the rich. So, it is these policies that need to be the basis of pro-poor growth - and they entail the removal of existing institutional and politically-induced biases against the poor. In short, growth is pro-poor when: a) it is labor absorbing, b) policies specifically mitigate inequalities, and c) policies specifically facilitate income and employment generation for the poor, especially for women and marginalized or minority groups.
9. So, to pass the litmus test above, a massive mobilization is needed...at-an-unprecedented-speed. The political choice to embark in this mobilization, both in the North and in the South, is the ‘joker in the pack of cards’ though. There are still manifold opportunities for powerful actors to evade their international obligation towards HR principles! With the lose way in which things are still set up, even otherwise powerful multilateral agencies remain toothless without the possibility of imposing sanctions on violators.
10. Having understood this, let’s be sure we do not miss an important point: For us, as HR activists - and from a HR perspective - EVEN ACHIEVING THE POVERTY-REDUCTION MDG BY 2015 IS ONLY A HOLLOW VICTORY: hundreds of millions will still live in poverty, die preventable deaths, and suffer preventable suffering.
11. Even with the prospects of only a hollow victory, it seems to me many world leaders have fallen in an ‘irrelevance trap’ best characterized by a caricature in which I see the theater director coming out on stage and shouting: "Fire!", but the audience not budging, because they believe it is part of the play: That is how I see politicians reacting to warnings that the MDGs will be missed.
12. Currently, governments are more concerned with inviting-in international consultants and with receiving international economic cooperation than about meeting the HR of their own people using locally feasible measures and resources. The resulting technical assistance sought by development projects has ultimately meant diverting attention from the real issues, the HR issues included.
13. Therefore, any convincing HR agenda must explicitly address the issues of poverty, gender and equity. It cannot be assumed that HR are inherently gender sensitive and will promote gender equality lest the HR framework explicitly focuses on gender issues from a rights perspective. But most governments are not politically committed to engage in gender equality beyond the benchmarks demanded by donors! For instance, most of the PRSPs submitted so far do not meet women rights’ standards; they contain nothing more than a collection of stereotyped measures of old-style-promotion-of-women-in-the-health-and-education-sectors.
14. Additionally, it is deemed that the HR agenda must examine
its contradictions with ongoing structural adjustment programs (SAPs).
At the national level, this means that the agenda is to
transcend SAPs to replace them with a HR-based program that is to directly
impact on government budgets, their spending priorities and on the funding
allocated to pro-poor programs.
Moreover, at the international level, since in practice poor
counties are (almost by definition) indebted, balancing their debt servicing
capacity has to be done against their de-facto actual allocating needed funds to
finance these pro-poor programs and NOT against their export earnings as has
been the case so far.
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Mostly taken from F+D, the IMF magazine, 40:4, Dec. 2003; D+C, the German development magazine 31:2 and 31:3, Feb. and March 2004; and the South Letter, the South Centre’s magazine, issue 39, 2003.
Food for a deceptive thought
1. In world affairs parlance, often particular words, short phrases and slogans briefly (or not so briefly) become fashionable; it may seem they do little harm. But, beware, thought is dependent on words. Cooked-up slogans can cover, hide and divert from reality. Many words and phrases are symbols and reflections of conceptual frameworks and economic and political schemes that influence (and can even distort) the political discourse and practices the world over. (Do ‘"the axis of evil", "coalition of the willing" and "pre-emptive defense" ring a bell?). With a good propaganda apparatus, these phrases can defend the indefensible.
2. Human rights (HR) work is not immune to such deceptions. Governments, international financial institutions (IFIs) and many a development agency or trans-national corporation (TNC) have indeed kidnapped and are misusing terms such as "democracy and HR", "human development", "human security" and even plain "human rights" and "peace". So, it behooves us to openly unmask these deceivers by denouncing the abstract and/or biased contexts in which they are using these otherwise very precise terms. After all, our disagreements with them are not only reflections of their verbal ambiguities.
3. Language has been a political weapon for ages. Used as such, it is not out to prove, but to sell - and, in doing so, it can devaluate any existing intelligent political discourse. This "double-speak" can and eventually does become intellectual dishonesty at its most perverse. Beware: Those who control the language, control the agenda. (J. Stauber, S. Rampton and E. Partridge)
4. Our mistake too often is that we think that facts can counter these slogans and will surely set us free...eventually! Many of us have, at some point in time, thought that if we can only get all the facts out there in the public eye, then every rational person will reach the right conclusion. But it has been and is a vain hope. When the facts do not fit the frames of important duty-bearers, the frames are kept and the facts are ignored. Frames matter; once entrenched, they are hard to dispel. A good part of the rulers’ conceptual framing is unconscious (as is ours!). The question is: How much do we have to change where-the-prevailing-values-are-taking-us to advance in our HR work? (G. Lakoff) [A good start is to say that the (new) HR framework will have to conform with what has been agreed to in the major UN conferences and Covenants over the past 20 or more years].
5. I think we simply have to analyze these conceptual frameworks to uncover which biases their proponents are coming from - and that is a political act. (*) Such an awareness does matter. Being able to analytically dissect and then to coherently articulate what is going on in the ‘frame’ in the background can change what is going on...if we choose to engage in the needed political debate that brings the underlying motivations to the fore! Such an exercise will also help us bring clarity to those leaders who hope to get concessions from governments that (passively at least) support the neo-liberal order for lack of alternatives.
(*):"The rich are getting richer; the poor are getting poorer": Typing this popular slogan into Google gives over 34,000 hits.6. In HR work, we acknowledge that most governments still need to address many unresolved questions about rights. Political leaders thus have to be well briefed in advance, and persuaded of the case for HR so that, once and for all, the HR perspective enters their ‘frames’.
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Mostly taken from the South Letter, the South Centre’s magazine, issue 39, 2003.
Food for a coercive thought
1. Given unequal relations of power, ‘legality’ and ‘legitimacy’ are mere window-dressing. The claims of the more powerful are simply enforced by overt or covert coercion and repression. People’s tolerance of social, economic and political inequalities and inequities (and human rights violations) never cease to startle me. (As much as our own ‘conformity-and-good-behavior’ - that by now has become an essential feature of our-belonging-to-and-being-integrated-in the reigning development paradigm).
2. Some kind of "wake-up-call" seems to be needed. And that is why social mobilization is needed. Without it, the marginalized somehow go on living with a chronic sense of insecurity caused by a) the exploitative processes eroding away their surplus, b) the essential resources they need to fulfill their rights not being made available to them, and c) the failure of governments to play a minimal human rights-protective role - all of this in turn caused by the exclusionary nature of the global political economy. That is why, through mobilizing the marginalized, we seek ways to eliminate all the exploitative and exclusionary mechanisms of the neo-liberal global political economy in the way that these mechanisms violate the rights of those being mobilized wherever they may be. It is in that way that human rights (HR) work ‘reintegrates’ the marginalized whose rights are being violated. And I am not saying this is easy...
2. Our peers have to progressively be pulled-up to work on the issues that, unless resolved, will leave those whose rights are being violated with their rights still violated, say, by 2015. It is high time for us to discriminate between what has been and what ought to be, i.e., converting rhetoric into concrete work projects. We are not trying to find a sort of ‘a middle way’, but a full taking-in-charge of the HR problematique. For that to happen, as said before, our work ethics must be politicized.
3. To be on the cutting edge, involves leaving comfort zones and moving along un-treaded paths. Only choosing ‘winnable’, short-term campaigns simply makes us ‘look’ to be successful. Longer term, HR struggles have to be undertaken, because they are important in-and-by-themselves; they may not be immediately winnable; they are often long and arduous - and there may be no one easily identifiable opponent. Our success will ultimately come from the sum of small steps making incremental inroads that, in time, will have a cumulative impact; many of our successes in the past have been so achieved. (S. Rachagan)
4. That is why a growing number of HR workers think that, in
many instances, HUMAN RIGHTS SHOULD BE TERMED "PEOPLE’S RIGHTS"!! Such a
terminology politicizes the concept in a way that "people’s rights" become
a rallying point for social mobilization; it becomes a process that emancipates
the voiceless directly involving them in the HR struggle, and gives them
legitimacy in the sense of a truly popular democracy.
In short, people’s rights bring the concepts of voice,
capacity and accountability to the fore, highlighting claim-holders’ and
particularly duty-bearers’ roles and responsibilities.
5. In preparing for this challenge, we should not underestimate the transformative impact of the use of the Internet. Why? Because the real challenge we face is that too many of us have not yet given our full attention and sufficient time and effort to HR work; ...and the electronic super-highway can help us to network and to rally growing numbers of us towards action. A global organization must have in place consultation processes that enable broad participation from all corners of the world. BUT global consultation - if done in-only-one-language and merely-through-electronic-communication (which for many groups in LDCs is still a luxury) - can legitimately be questioned. And I do not (yet) have an answer for this legitimate caveat. I only know that this new medium must be used together with the traditional ones (newsletters, radio, newspapers, TV, face-to-face interactions).
6. Acting as a coordinated network is a formidable challenge by itself, one we cannot pretend does not exist: But rise above it we must! Participatory and democratic processes at the center of networking do not guarantee consensus; in fact, they often reveal dissent; a common position can only be arrived-at with compromise. [Better a diamond with a flaw than a pebble without one, Confucius would have said].
7. In HR work, campaigning and capacity building are, therefore, mutually supportive strategies. We need to renew and reinvent the HR movement in a way that our efforts are always on behalf of those who need our solidarity most; failing to do so will mean that we risk becoming irrelevant. From now on, we need to move beyond lip service (and beyond these HR Readers...) and ensure that HR priorities are always reflected in the manner we allocate our time and the very limited resources we individually or collectively control.
8. Things are happening slowly in this domain though. This Reader, I hope, is part of it. The challenge now is that the current flicker of hope bursts into a flame. (*)
(*): I often fear that these Readers may be coming through as lecturing rather than informing and providing action-oriented food for thought; I fear that the content may sometimes suffer when the rhetoric is hot. But one thing is clear: I do not shy away from polemics when discussing the major issues related to the politics of HR. I am undeniably controversial, but, then, trying to break down common beliefs, especially if inaccurate or blinding, is always fraught with controversy. As much as I can, I try to look beyond one-sided and narrow explanations so as to gain a stronger understanding. The Readers present ‘the other side of the debate to technological and sectoral approaches to development - always striving to expand the awareness on the depth, complexity and resilience of combating HR violations. In a neo-liberal sense, I guess, I could perhaps simply be accused of taking-controversial-ideas-to-market.9. I am a firm believer that wo/man is so made that whenever something fires her/his soul, impossibilities vanish. (J. de La Fontaine)
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Mostly taken from F+D, the IMF magazine, 40:4, Dec. 2003; D+C, the German development magazine 31:3, March 2004; the South Letter, the South Centre’s magazine, issue 39, 2003, and the Asia Pacific Consumer magazine, Vol. 34, April 2004..
Food for reversing a faulty process of thought
1. NGOs became players on the political and human rights stage (HR) long ago - both at the national and the international level. As such players, in the Third World, many of the Northern NGOs have unfortunately too-often-and-for-too-long worked with authoritarian regimes. Anyone who, too-often-and-for-too-long, backs the wrong partners without criticizing them creates her/his own reputation. Only having a strong moral vision does not per-se result in having moral influence.
2. Going back to their origins, many NGOs working on development issues were, from the outset, linked to economic liberalism (perhaps also to feminism and religion).
3. Coming from a moral-theological perspective, these civil society organizations stand for securing ‘civilized social contracts’; they thus further tolerance and plurality in thought. Nothing wrong with that. But perhaps the time is over for this path, because, on the basis of existing socio-economic inequalities and widespread human (people’s) rights violations, much of civil society itself contributes to the reproduction of these inequalities and the persistence of these violations.
4. So, the question is whether, today, the NGO concept has the potential to deliver the structural and HR changes needed under the current ‘conditions-of-Globalization’. These conditions are destroying livelihoods. Globalization is neither a natural process nor an inclusive one; it is rather a planned project, and one of exclusion. More than anything, Globalization is completing a project of re-colonization. Growth through Globalization is importantly based on the theft of people’s resources, knowledge and economies. In the Globalization paradigm, the protection of people and the protection of nature are replaced by corporate protectionism. The rules of this imposed market-competition-dogma simply transform all aspects of life into markets. (V. Shiva) Moreover, social and employment concerns are never brought to the forefront in the process of Globalization. Globalization does not create jobs; as a matter of fact, it is a hotbed of anti-union activity.
5. Under Globalization, change creates both (a few) winners and (an army of) losers. It therefore behooves NGOs (now being euphemistically renamed civil society organizations by the World Bank) to work on strategies to revert this process and to find ways to work with the current losers in interventions that more proactively distribute the benefits of change more equitably.
6. Because of this, there are those who now dissociate themselves from the NGO concept and opt for a more radical and militant perspective: one of social-mobilization-cum-political-consciousness-raising (a-la-Paulo-Freire).
Where in this continuum would you place yourself?
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Mostly taken from the German development journal D+C, 31:2, 2004 and from Poverty, Health and Development, Health Cooperation Paper No.17, AIFO, Bologna, Italy, 2003.
Food for a hindered thought
1. In a free-market world economy, Third World countries are not being given the benefits they and their economies need, but rather what-ideologically-motivated-Northern-trade-partners believe they should give them. Conversely, in the local economy, only those who have something to sell - and are not hindered in selling it (!) - can earn anything from trade.
2. So, when trade rules threaten the right to food of the poor, those trade rules should be challenged on the basis of existing Human Rights Covenants. Therefore, states, independent human rights commissions and/or NGOs should undertake ‘human rights (HR) impact assessments’ of the trade rules the respective country abides by, both during the process of trade negotiations and after negotiations; such an assessment must be public and participatory so as to safeguard people’s and communities’ rights from the avariciousness of commercial interests and patent rights. (AIFO)
3. Often, human rights work also ends up calling for better governance. But this concept is interpreted to mean many different things.
4. For the developed countries of the North, it means shaping states’ policies worldwide so as to create the environments-most-favorable-to-the-opening-up-of-the-countries-of-the-South-to-globalized-free-markets! It means forcing the hand of these countries to adopt neo-liberal economic policies. The aim here is not really to foster greater democratic participation, but rather state-sponsored market deregulation.
5. This being the case, one can justifiably ask: When creating such ‘favorable’ environments, has neo-liberalism been able to manage the crisis of the world system? And the answer has to be a resounding NO. This latest stage of Capitalism has actually not yet shown it can curb the growth of impoverishment in large segments of both the Third and the First World.
6. By now, we all know neo-liberalism is not a development
model, but a domination model! Period.
So, we do not need this kind of moralizing rhetoric about good
governance.
7. As understood from a HR perspective, the hallmarks of good governance, are: democratic and impartial institutions; the diffusion of information to the public; transparency in decision-making; the participation of all actors; free and fair elections; efficient management of resources; expert competence in assessing situations; accountability; integrity; AND explicit respect for human (people’s) rights. These hallmarks will be sought in vain as long as the structural obstacles that prevent the vast majority of countries of the world from exercising their right to development and to democracy are not removed. This fact leads committed HR workers to a very clear path of where the priorities lie. The crude reality of our times has simply led to levels of inequality beyond tolerance.
8. All this emphasizes what this Reader has said many times before, namely that, if the context and the framework of our development discourse are wrong, discussions and actions based on the wrong analyses will be like pouring water into a broken vessel; no amount of effort to fill it will be sufficient.
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Mostly taken from several Third World Network publications.
Food to make a big dent on a thought
1. Respecting and fulfilling human rights (HR) has a cost indeed - maybe even in terms of economic growth foregone. But solidarity, fairness and justice are also values that count - perhaps more than growth - when wealth is relentlessly concentrating in fewer and fewer hands: Disparities in global income are simply worsening.
2. As part of these inequalities, in the 21st century, it is a fact that, in rich countries, it has become cheaper to buy an extra year of life; buying an extra year of life in poor countries has also become somewhat cheaper: But by far and increasingly more unaffordable.
3. The inequalities we refer to arise from the rich being made better-off at a faster pace than the poor. (Unbelievably, many of the rich see this as "not-a-bad-thing" since this windfall bonanza comes really "at no-one’s expense..." (??) Worldwide, we are told that the "average-global-citizen" (does such an animal exist?) has become wealthier - but this is of little comfort for the 2 ½-3 billion poor people living in developing countries.
4. In 2001, more than half the low income countries (population 800 million) had per capita income growths of less than 2%; nearly one third of them (225 million) had negative growths. This, at a time when OECD countries subsidized their agriculture at a level of U$850 million a day, or U$360 billion in 2003 alone. (This equals six times their overseas development assistance and is costing the world’s poor countries about U$24 billion a year in lost export income...not to talk about the expenses of U$200 billion in Iraq).
5. Inequalities are of such a magnitude that reallocating a
relatively small part of the income of the 10% richest group (e.g., through
progressive taxation, property taxes, luxury goods taxation, a Tobin-type tax,
land reform) can potentially make a big dent in the income of the poorest
20%.
If this is not a human (people’s) rights issue, I would
not know what is....
So, what am I (you) to do as a HR activist?
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Mostly taken from Finance and Development (the IMF journal) 40:3, Sept 2003.
Food for a thought in the political sphere
1. Human rights (HR) violations are varied and dynamic; they and/or their character and intensity change over time. Commonly found patronage (clientelism) and exploitation structures find ways to perpetuate these violations by quite systematically preventing changes that could reverse them. For sure, there is now a greater recognition of the political roots of HR violations, and these clearly change over time. That is why, to ensure a principled and consequent approach to development interventions, we now need to integrate capacity (accountability) analyses in all HR-based approaches to development planning - and do so repeatedly and on an ongoing basis, because power and wealth relations simply also change over time.
2. Therefore, vulnerability to HR violations is now rightly understood more in terms of powerlessness rather than simply as a lack of resources to uphold and sustain these rights. (*) People are most vulnerable when their livelihoods and coping strategies are blocked, or if their group identity, political position or material circumstances make them particularly exposed to exploitation.
(*): Keep in mind that credibility is a central issue in power relations. Without access to knowledge, it is not possible to have power; knowledge of existing legal instruments is particularly important as a source of power.3. For human (people’s) rights to be upheld under any political system, duty-bearers need to be monitored (including political leaders since holding elections and embracing a multi-party system does not necessarily guarantee more democracy or a better HR agenda).
4. Development agencies and NGOs thus need to understand this
dynamics-of-vulnerability-and-power in all societies in which they operate. The
bottom-line question is: ‘Through their work, are they doing ‘maximum
good’? While the practical constraints to this maximization are
considerable, the tools to maximize good have long been there. So, the most
significant challenge is an institutional one, i.e., how these agencies are to
integrate a (political) HR capacity analysis into the mainstream of their
activities at all levels. This is a challenge, because the
powers-that-shape-things are, first and foremost, in the political sphere: so we
all have to deal with them in that sphere.
After all, development IS the realization of civil,
political, social, economic and cultural rights.
What this means is that the achievement of HR has to be the
overarching objective of development processes.
5. Unfortunately, the educational and scientific institutions that prepared us and are guiding the future of our upcoming colleagues (and leaders) have only responded marginally to the challenge posed by now having to use the emerging HR-based approach in the training of the new generations of development professionals.
6. ...And related to what Development with a capital D ought to be, have you noticed that no actual Development Strategies are announced anymore? Only ‘goals’! But goals are not strategies! They are statistical objectives. You can only achieve a goal if the path to it is described...
7. Therefore, I contend that the Millennium Development Goals are primarily a rhetorical device. You disagree? Then, consider for a moment that - for the specific poverty reduction MDG - even those who pass the $1/day mark by 2015 may still stay between 1-2 dollars a day...forever. (F+D)
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Mostly taken from the German development journal D+C, Vol. 30, Dec, 2003 and Vol. 31, Jan, 2004 and from F+D (the IMF journal) 40:3, Sept 2003, as well as from Poverty, Health and Development, Health Cooperation Paper No.17, AIFO, Bologna, Italy, 2003.
Food to transform apathy into an action-oriented thought
1. In their work - and not that this is easy - human rights (HR) activists ought to make practical experiences influence theory, as well as use theoretical considerations in their practice. The idea is that a progressive engagement in human (people’s) rights work should lead to an activism in which profession, compassion and political solidarity become one and the same thing.
2. S/he-who-has-no-bearings just goes round in circles. This is why this Reader aims at persuading other people to spend more time and energy on HR work. We need to build up this capacity to motivate others so we all start from our ‘new’ selves. (At least one person who got influenced by the Reader is myself...)
3. Apathy can turn our work into stagnation. We need to transform-apathy-into-activism and to consolidate-negotiated-social-contracts between people (as claim-holders) and their representatives (or purported representatives) at all levels (as duty-bearers).
4. I think that visionaries who communicate their vision to others are the true realists of history.
5. We need to shift our attention from just reaching-the-poor-merely-as-an-extension-of-the-prevailing-paradigm to a-deeper-understanding-of-the-issues-of-poverty-and-inequality-and-their-underlying-processes. What ultimately counts is our social and political accountability and our work in true partnership with the poor.
6. We also need to explicitly recognize that political-processes-and-issues-of-power determine the content, direction and implementation of HR policies and programs. Together with the marginalized and poor, as HR activists (and from within our respective professions), we can and should become strong political players instead of implicitly protecting narrow group interests through our work under the wings of governments, industry and international agencies that are most often unmindful of the real interests of the poor, despite their (and our) public statements to the contrary. (T. Narayan)
7. It is ultimately our networked power and strength that will achieve higher levels of emancipation and that will eventually reverse HR violations in all domains.
8. [A word of caution about networking in our empowerment
efforts: The noisy kind of street democracy of protesters at World Bank/IMF, WTO
and Davos-type gatherings has to get its act together. The cacophony of
thousands of voices that may no-longer-hear-one-another risks squandering
wonderful young energy if no coherent agenda for the future is put forward.
Protesters (middle-class activists?) need now to develop or adhere to a whole
set of new universal values in the name of which they propose new systems of
governance; and this has to lead to agreement among the more committed sector of
organized civil society; only thus will protesters make their reasoned
collective case heard].
[But also note that, in our case, using the streets to spread
and defend the principles of HR and to popularize our HR work is, I think,
indeed legitimate].
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Mostly taken from the German development journal D+C Vol 31, Jan 2004 and from Poverty, Health and Development, Health Cooperation Paper No.17, AIFO, Bologna, Italy, 2003.
Food for a bottom-up thought
1. It has never been proven that improving the provision of services through privatization is the best approach to the problems of public sector inefficiency. Give the public sector the hidden or overt subsidies the government quite invariably gives the private sector (already) and the public sector may well perform better than it has done so far working on shoe-string budgets. OK, but is this enough?
2. No. Actually, to make services work for the poor, the poor need more control over those services - not privatization. This, because services are failing poor people; because governments are spending too little on poor people. (World Bank’s World Development Report 2004)
3. In the provision of services, empowerment of the poor strives to enhance-beneficiaries’-power-over-providers (also called ‘the short or direct route to accountability’). But the vested interests that are effectively blocking the poor’s access to better services will resist reforms leading to greater power for beneficiaries.
4. The side on which we ought to be in this struggle is clear. Putting our energies on improving the provision of services for the poor from the top down is not an intervention that promotes human (people’s) rights per-se.
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Mostly taken from F+D (the journal of the IMF) 40:3, Sept 2003.
Food for a thought beyond survival
1. Processes are occurring every day that make people poor. So, it is legitimate to ask: Where is the end of ‘survival’ and where the beginning of ‘living’?
2. Being poor, changes people’s incentives and the set of constraints under which they operate; it results in a prolonged sense of helplessness.
3. The bare fact is that poor people are excluded from their share in the wealth they help to create. That is why the distribution of wealth is as important (if not more) as its creation.
4. Because individuals experience poverty and the violation of their rights differently - according to their gender, age, caste, class and ethnicity - injustice has to be seen through the eyes of ‘those-who-are-farthest-behind-on-the-road’ in all of those categories. (Halfdan Mahler)
5. Some are of the opinion that poverty is a rather static concept; they prefer using the concept of vulnerability which, they say, is more dynamic and is also found at individual, household and community level.
6. Furthermore, poverty and inequality are actually a source of economic inefficiency since both waste human potential.
7. For us in human (people’s) rights (HR) work, poverty is related not only to its economic aspects, but is multi-dimensional. It is related to powerlessness, to not-being-counted, to not-being-considered, to being-excluded, to being-unheard. Poverty is related to exploitation, oppression, victimization and violence. It is also related to migration, forced displacement, rising urbanization and loss of livelihoods. (Final AIFO Document)
8. As regards health, in our societies, much of health has become a ‘medical-repair-industry’ of the damage-done-by-poverty (H. Mahler); this so much so that, in fact, WHO has created a new category of disease actually called "Extreme Poverty" (ICD 10, No. Z 59.5).
9. A sustainable approach to poverty reduction is complex and requires that three types of measures be taken to ensure: a) that the improving poor continue to improve; b) that the coping poor graduate out of their precarious state; and c) that the declining poor have an opportunity to reverse their condition. (U. Narayan)
10. Poverty being forced on individuals and families who do not have any other choice is unequivocally linked to injustice - and potentially to rebellion. It represents a-denial-of-human-rights-on-a massive-scale. Should this fact not make a difference in (y)our everyday work?
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Mostly taken from Poverty, Health and Development, Health Cooperation Papers no.17, AIFO, Bologna, Italy, 2003
Food for the basically wrong thoughts that we need to be aware of
1. Human needs provide a critical grounding for human
(people’s) rights (HR). Not all needs correspond to rights though, and not
all rights correspond to needs.
But a central set of human rights rests on basic human needs.
HR are often impeded by "wrong" social and political structures or adverse
environments in those domains, i.e., the socio-political conditions that are
required to sustain HR. The needs-based approach looks for causal factors rather
than for ‘deliberate acts by evil actors’. (J. Galtung). Using
capacity (accountability) analysis, the HR-based approach looks for
both.
2. The primary role of the HR-based approach is to make people aware of what-is-basically-wrong. And when this is widely acknowledged, it has to be pointed out to people that there are legally-recognized-and-binding-instruments-to-right-these-wrongs. Ergo, the poor and marginalized have legitimate claims in the struggle for the fulfillment of their needs.
3. Consider the example of the international debt of low-income countries: By the late 1990s many very poor countries paid more in debt service to rich countries than they spent on education or health. Typically, their education and health budgets have been cut at the insistence of international financial organizations. Sacrifice of these basic needs, in order to service debt, is unacceptable. ‘Jubilee 2000’ campaigners for debt relief have shown how such cuts contravene the Universal Declaration of Human Rights (UDHR) endorsed by nearly all governments, including the debt collectors’. The UDHR prioritizes access to education and health care. [Even in welfare-states, when a family goes bankrupt, no child is expected to lose access to basic education and health care in order for debts to be repaid first; this principle should apply for people everywhere!].
4. Ultimately, rights-are-justified-claims towards the protection of persons’ most basic needs and dearest interests; they are justified-priorities-that-give-people-basic-claiming-capabilities to achieve them; rights convey respect to persons-as-choosers, as active rights-claiming, choice-making agents.
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Mostly taken from ‘Needs and Human Rights’, Des Gasper, in ‘The Essentials of Human Rights Encyclopaedia’, (forthcoming).
Food for thoughts (and deeds) that go unsanctioned
1. In international law, a violation of human rights (HR) is deemed to be an offence, not only against the state, but also against all members of the international community. But unfortunately, this does not necessarily imply an international crime, so that many HR violations do not actually call for public/worldwide action. Ergo, force and sanctions cannot be used in the case of despondency towards poverty alleviation, low and unfair pricing of commodities (food included) and against the inequitable provision of health care and educational services.
2. The question is: Does the international community have the responsibility to intervene legally in cases of clear violations of the right to food or to health, or to education? In a utopian world, perhaps yes. However, the direction in which HR ‘soft laws’ are applied, the inherent responsibility is vaguely given to international development organizations instead.
3. This vagueness in the language of international law is
problematic, because it allows for the manipulation of this
inexactly-defined-body-of-laws. There is an urgent need for further codification
of this body of international law related to HR. But, in today’s world, the
codification of international law is a reality we can only dream about. The US,
for example, is consistently disrespecting international law by not ratifying
treaties it has signed. The US will certainly veto any codification of
international law that may hold it responsible for its actions, both
domestically (e.g., CO2 emissions) and overseas (e.g., the International Court
of Crimes Against Humanity). This begs the question: If there is no codification
and no means of enforcing it, what is the point of this international
law?
From unenforceable laws come no rights!
4. International law is primitive and subject to individual countries’ recognition of each norm as being a legally binding norm. Because the international community lacks a central authority, the creation of international law is consensual through treaties. Treaties are documents often bilaterally or multilaterally signed that are agreements by governments who consent to be bound by their contents. Treaties fall into the category of ‘soft law’ (documents that are not directly enforceable in courts and tribunals, but that nonetheless, have an impact on international relations). Many such international agreements may prove useful and may serve as a basis for future legally binding agreements.
5. However, the name given to these laws (‘soft laws’) is inherently problematic, because soft law is not law at all. Essentially, soft law is comprised of declarations of principles, codes of practice or conduct, recommendations, guidelines, standards, charters and resolutions. These instruments have no legal authority, but there is an expectation they will be respected and followed by those countries and governments who have signed them.
6. One problem with non-legal instruments is that countries can sign on to them without the fear of having to be held accountable - legally. Pressure comes (or is supposed to come) from the international community. But it is only an assumption that, if a treaty is signed, a country will do everything in its power to maintain the integrity of the contract.
7. While the analogy is only approximate - because there actually is enforceability and punishment for people driving too fast - there are some parallels between the importance of international law and the importance of signs marking the speed limit in a highway. When the speed limit is 100 km/hr, one can assume that traffic will be moving at an average of 105-110 km/hr. So, if the speed limit is 100, why do people drive 5-10 km/hr faster? The answer is simple: If there were no speed limit signs, people would drive at 120 or more km/hr. The speed limit signs work as a limit of what is acceptable. People cross that line all the time, but they measure their breaking of the law according to the line. Treaties signed by governments put forth by the international community serve as the line equivalent to the speed limit sign, in a way serving the same purpose.
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Mostly taken from a 2004 course term paper by Noah Levinson, gbnl@aol.com.
Food for the most principled thoughts
Universality and indivisibility
1. Every woman, man, and child is entitled to enjoy her or his human rights simply by virtue of being human. It is this universality of human rights that distinguishes them from other types of rights - such as citizenship rights or contractual rights. The principle of universality requires that no group, including geographically remote communities, be left out of the reach of development assistance and public policies. Despite widespread recognition of the universality principle, many still question its validity. This is easily countered by applying what has been called the Ramcharan test of universality. "Just ask any human being: Would you like to live or die? Would you like to be tortured or enslaved? If there is any critic of universality who would argue that an individual would choose death to life, and serfdom to freedom, let us hear from that critic."
2. Human rights are indivisible. Enjoyment of one right is indivisibly inter-related to the enjoyment of other rights. For instance, enjoyment of the highest attainable standard of health requires enjoyment of the rights to information and education, as well as the right to an adequate standard of living. All human rights - civil and political; economic and social - should be treated with the same respect. Policies and programs should not, therefore, be aimed at implementing one particular right alone. However, the fact that all human rights should be accorded the same respect does not preclude priority-setting in programming support. The scarcity of the resources and institutional constraints often require us to establish priorities, for instance favouring the rights to food, basic education, and health.
3. Poverty encroaches on a set of rights that cannot be subdivided into separate rights. Some insist on the immediate protection of civil and political rights, while conceding that economic, social, and cultural rights depend on affordability. This distinction is artificial, for two reasons: first, there is no clear-cut division between civil/political rights and socio-economic rights; second, all rights have resource implications. By ratifying human rights conventions, a state takes-on the obligation to provide material assistance and to support programmes for the poor, including through international cooperation.
Equality and non-discrimination
4. Human rights are for everyone, as much for people living in poverty and social isolation as for the bright and educated. International law prohibits discrimination in the enjoyment of human rights on any ground, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth, or other status. The term, "or other status" is interpreted to include personal circumstances, occupation, life style, sexual orientation and health status. People living with HIV and AIDS, for instance, are entitled to the enjoyment of their fundamental human rights and freedoms without any unjustified restriction.
5. Equality also requires that all persons in a society enjoy equal access to the available goods and services that are necessary to fulfil basic human needs. It prohibits discrimination in law or in practice in any field regulated and protected by public authorities. Thus the principle of non-discrimination applies to all state policies and practices, including those concerning healthcare, education, access to services, travel regulations, entry requirements and immigration.
Participation and inclusion
6. An essential principle of the international human rights framework is that every person and all peoples are entitled to participate in, contribute to, and enjoy civil, economic, social, cultural and political developments in which human rights and fundamental freedoms can be realised. This means that participation is not simply something desirable from the point of view of ownership and sustainability, but rather a right with profound consequences for the design and implementation of development activities. It is concerned with access to decision-making - and is critical in the exercise of power.
7. The principles of participation and inclusion mean that all people are entitled to participate in society to the maximum of their potential. This, in turn, necessitates the provision of a supportive environment to enable people to develop and express their full potential, voice and creativity.
Accountability and the Rule of Law
8. States have the primary responsibility to create an enabling environment in which all people can enjoy their human rights, and are obliged to ensure that respect for human rights norms and principles is integrated into all levels of governance and policy-making. The principle of accountability is essential for securing an enabling environment for development. Human rights do not simply define the needs of people, but recognise people as active subjects and claim-holders, thus establishing the duties and obligations of those responsible for ensuring that needs are met. As a consequence, the identification of duty-bearers has to feature as an integral part of program development.
9. Rights themselves must be protected by law. Any dispute about them is not to be resolved through the exercise of arbitrary or discretionary procedures, but rather through adjudication by competent, impartial, and independent processes. These procedures will ensure full equality and fairness to all parties, and determine the question at issue in accordance with clear, specific, and pre-existing laws, known and openly proclaimed. All persons are equal before the law, and are entitled to equal protection. The rule of law ensures that no one is above the law, and should ensure that there is no impunity for human rights violations.
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Taken from Urban Jonsson (Senior Advisor on Human Rights-Based Programming, UNICEF), ‘A human rights-based approach to programming (HRBAP)’, Final Draft (25 June 2004).
Food for the right thoughts in health
I. The meaning of the human rights (HR) discourse in health:
1. The revived interest in a HR-based approach to development and to work in health and nutrition is well justified and an advantage over our current approach. HR - and the right to health - have a particular concern about those who are disadvantaged, marginalized and living in poverty.
2. Widespread unsatisfied health needs, primarily of the poor who lack economic access to health services (and are now faced with widespread fee-for-service charges), represent flagrant violations of the rights of a majority of people. This is to be seen in good part as a failure of beneficiaries themselves to act as empowered claim holders placing their demands from a power base that can force non-performing duty bearers (individuals and institutions/organizations) to provide the services and resources needed to reverse those violations.
3. We have become quite good at doing detailed Situation Analyses of unfulfilled needs and entitlements. But these only list and sometimes characterize the multiple violations of the right to health. So these represent diagnoses only. Moreover, entitlements and needs do not carry correlative duties for duty-bearers. Rights do!
4. To get something done about these violations we have to further embark in Capacity Analyses that look at who is supposed to do what about each of the violations we document (and why they are not doing much or anything). Capacity Analyses have also been called Accountability Analyses, because seeking accountability provides claim holders with the opportunity to understand how duty bearers have discharged their obligation and provides duty bearers with the opportunity to explain their conduct.
5. After carrying out these capacity analyses, we have to - in an organized way, through proactive community mobilization - embark with the beneficiaries in doing-something-about-those-violations, knowing exactly who needs to be approached/confronted and with what specific demands.
6. All unfulfilled needs, by definition, cause some kind of harm (by omission). But the satisfaction of basic needs does not carry a legal obligation for decision makers - though perhaps a moral obligation. But moral obligations have not been sufficient to satisfy the numerous violated rights of the poor in the last 40 years (or more) of Northern-led development.
7. Unfulfilled-needs-and-entitlements-seen-as-violations-of-human-rights, on the other hand, DO bind duty bearers legally under international law and, among other, under the Constitution of the World Health Organization (WHO). Most countries have signed the respective UN HR Covenants - and this is the most important...we are now demanding duty bearers to legally uphold what has been signed by their respective countries and has now been sanctioned by the international community.
8. Moreover, the Constitutions of over 100 countries include the respect of health-related rights; courts around the world are already adjudicating cases involving the right to health. There is thus now a growing body of international HR law and practice to help us identify the specific interventions and policies that are needed to achieve human (people’s) rights goals in health. Therefore, the challenge now is to bring the right to health to actually bear upon local, national and international policy making processes. It is to be noted that proactively influencing policy making in health does not depend on winning related HR court cases; the policy-influencing approach is not a soft option; it calls for forceful social mobilization: It is not about listening to the powerless and marginal; it is for the latter to be empowered to demand accountability for key structural changes not occurring without a push. The court-based and the policy approach are thus mutually reinforcing and both should be used in our struggle; we thus need to promote and mobilize people for both. What is now left is to implement all these practices that operationalize the right to health at the community, national and international level by addressing issues of poverty, discrimination and stigma face-on, particularly in relation to gender, children, racism, HIV/AIDS and mental health issues.
9. All this represents an important quantum jump in our prospects to achieve some of the changes we want to see being implemented in health and in society.
10. It needs to be emphasized here that reaching the MDGs also will have to pass through breaking the poverty syndrome behind pretty much all the indicators of the MDGs. In our case, looking at these goals only through the prism of the right to health will only advance our cause in the health indicators (goals), i.e., a very partial victory. Many are calling for specific ‘contributions of the right to health to poverty reduction’. I rather see it the other way around: "how-will-poverty-reduction-contribute-to-the-right-to-health". (Or, at best, we see it both ways, but not the former way alone). I am NOT seeking pro-poor health policies! I seek "pro-health-poverty-reduction-policies"!
11. The HR cause gives us the possibility to advance our political agenda towards equity, towards the indispensable structural changes that need to be made for health and other social services to receive the resources they need to reverse the corresponding rights currently being violated.
12. If not willing to cooperate, we now can face duty bearers accusing them of violating international law. And that is a tactical advantage. We can now demand structural changes under the wing of international law. Our challenge now is to spread the word about this so that, in alliance with claim holders, we can muster the power to give a new direction and greater momentum to our struggle for ‘Health For All Now’.
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Food for the right thoughts in health (2)
II. How to strengthen the HR-approach in our work in health:
13. The more specific challenge we face is to incorporate the HR-based approach into the Health For All Now agenda. The popularization of what the human (people’s) rights discourse means, as characterized in a very simplified way in Part 1, is step one. We need to do this first with our strategic allies in bilateral, multilateral and non-governmental organizations. Several of them have already started: UNICEF has taken the lead among UN agencies to set the course of what needs to be done to apply the HR-based approach in development planning; CARE has made substantial advances in adopting a HR-based approach in its operations worldwide. The fact not withstanding that most government and non-governmental development agencies have not yet re-visioned and re-missioned themselves to adopt a HR-based approach, there is much we can learn from the two experiences cited here (See U. Jonsson’s book, ‘ The HR Approach to Development Programming’, UNICEF, Nairobi, 2003 and CARE’s ‘Promoting Rights and Responsibilities’ Newsletter, aswani@care.co.ke).
14. In step two, it will be for these allies to then bring the new concepts to their colleagues and peers, as well as to a host of different health workers in their respective workplaces and then to community leaders in the areas where they work.
15. The incorporation of capacity analyses to identify and characterize duty bearers that are not doing what needs to be done will, from now on, be key to our work. This process is in itself empowering for us and for the claim holders we work with. (see www.humaninfo.org/aviva)
16. Both in steps one and two, it has to be emphasized that there is no hierarchy of HR; there are no ‘competing rights’. All rights are universal and inclusive, so we have to work for their fulfillment in all areas; that is why looking at ‘Health for All Now’ as a key element of our struggle for the drastic reduction of poverty is crucial.
17. The neoliberal development paradigm tries to fragment the social reality into sectors allowing partial small victories to be hailed as successes alas with absolutely no sustainability. If the system that causes all the symptoms and signs that come with poverty is not fixed, small victories in health, in education or any other sector are just deceiving us. For example, the emphasis on trade that globalization fosters is not going to benefit the poor unless we specifically build-in fair trade rules AND mechanisms of distribution of the benefits of trade to the lowest income quintile. Or, an example from the health sector would be: We have seen Herculean efforts and resources being poured into the Expanded Program of Immunization; who could fault that when it saves lives? But saves lives for how long? Until the child saved from dying from one of the six immunizable diseases, because s/he is malnourished and lives in a poor and contaminated environment, falls prey to a pneumonia or a diarrheal episode for which we do not have a vaccine yet? Who are we fooling here?
18. What is highlighted here is that we cannot let the forces of status-quo hijack the concept of HR in health. Any partial/sectoral interpretation of this concept is ultimately dishonest. HR is about a more equitable distribution of resources in society and health is one of many entry points to achieve this goal.
19. Human beings are born with a right to health and society has to proactively make the investments to prevent ill-health and malnutrition and to treat those affected by the diseases of poverty. Focusing our efforts in anything short of this is a job half done, more so if we do not arrive at such a situation through the empowerment of claim holders themselves to relentlessly demand that the needed changes are implemented. This is not a task for an avant-garde only: it is a mass mobilization task.
20. I am not saying that all this is easy, or fast, or that there are no small victories on the road to achieving our main objectives. But the focus has to remain on the big picture....do not miss the forest!
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Food for a thought that is here to stay
1. The human rights-based approach (RBA) represents a historical evolution from clientelism to citizenship. It is still often contested by many development agencies; at best, their statements on the RBA tend to reflect ‘a compromise’ on the issue. [The World Bank, for example, is ‘cautious’ about human rights (HR) in its official remarks; many bilateral donors are interested, but promote fairly watered-down definitions of HR - mostly relating them to civil and political rights only]. But, regardless of this attitude, the RBA is here to stay and to stay as a crucial link in our current attempts to eradicate poverty - any efforts to ‘sanitize’ its underlying political processes notwithstanding.
2. Deciding which rights are most important has also become a political debate. We still stand firm on the principle that human (people’s) rights are indivisible. Nevertheless, we can agree that the right to participation can be seen as the entry point to realizing all other rights: it is the-right-to-claim-other-rights. For this, excuse the obvious, participation has to be understood as a right, and not as an instrument for greater aid effectiveness. This alone means switching from a technical to a political understanding of development, one that facilitates-the-inclusion-of-the-voices-of-the-marginalized who currently face barriers that prevent them from claiming their rights: The rationale of poverty reduction no longer derives from the poor having needs, but from them having rights!
3. The RBA is all about struggling for greater global distributive justice - including claims to aid, to debt relief and to fair terms of trade. It does not talk of (voiceless) beneficiaries, but of (partner) citizens, i.e., someone with rights rather than someone receiving welfare. Centering demands on people’s rights means that our work will often entail extracting concessions from the more powerful duty-bearers who run the government and or otherwise control the needed resources. So one of the major challenges for poor people is to use the legal system to promote justice - making the laws work for them rather than for the elites. In this sense, rights are shaped by the actual struggle of people, i.e., through them acquiring and using a new understanding of what they are justly entitled to. That is why rights sound threatening to governments and/or elites; they are caught off-guard in responding to these new demands and may react in politically unpredictable ways. That is why agencies engaging with their partners in using a RBA must act responsibly and use the right tactics when supporting the powerless to take action; this, since they risk starting a struggle they are not sure to win.
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Mostly taken from IDS Policy Briefing Issue 17, May 2003.
Food for a newly prioritized thought
1. At this stage of our shift to a human rights-based approach (RBA) to development, the questions we now hear have changed from ‘What is this RBA?’ and ‘Why do we have to adopt it?’ to ‘How do we adopt a RBA?’ and ‘What practical differences will the RBA make?’. People are also asking for proof that programs that use the RBA have an increased impact on reducing poverty and promoting social justice. All these questions are being answered by a steadily growing number of experiences that are coming from the field.
2. What is clear though is that rights-based initiatives can only be sustainable if they focus on creating, widening and/or taking advantage of the political space inside which marginalized groups can (and do) claim or assert their rights themselves. A development agenda that seeks to encourage active citizenship requires an understanding of the political economy of the specific localities in which one works-in, as well as the larger (global) context within which the same is embedded. Eventually, human rights (HR) activists have to come to understand the entrenched patron-client nature of social relationships that govern nearly every aspect of rural life in the Third World. Strengthening local democratic processes and steering clear of actors that use force to achieve their means is what the RBA really promotes.
3. Working with a human (people’s) rights perspective requires that projects re-orient their existing organizational structure and that their staff actively engages in the complex day-to-day-politics of the localities where they work. Projects have to re-interpret their logical frameworks (if they have them) so they get actively involved in addressing the basic causes of social, political and economic marginalization - and challenge these causes as the partners of choice of the poor. A quarterly internal project newsletter can be of help to further such a cause.
4. Given what is expected today, civil society organizations (NGOs included) need to appoint rights-and-social-justice-coordinators, need to prepare ad-hoc training modules on HR, need to organize ‘think tank-type’ working groups on HR issues who have to get involved in research and analysis of existing policy guidelines, as well as laws and regulations pertaining to HR. In short, a realignment of staffing is fundamental and a system-of-mentoring-and-guiding has to be put in place in the areas of rights and social justice, both for professional and field staff. Ultimately, staff members have to become facilitators-of-HR-processes and not mere implementers of projects.
5. Objectives related to HR and advocacy have to be incorporated into the annual operation plans of these organization; the job descriptions of all staff have to be rewritten to include new responsibilities pertaining to their rights work. This will require a dialogue centered on the questions ‘Who are we?’ and ‘Who should we be’ in our work? In the end, staff members have to analyze the relevance of what-they-are-working-towards and to build their confidence as they dispel the fear that the RBA cannot be implemented. They also have to be prepared and commit themselves to take their rights work into uncharted political territory - and this should define the behaviors they should take up in everything they do, i.e., promoting empowerment, working in partnership with others, ensuring accountability/promoting responsibility, opposing discrimination and violence and seeking sustainable results.
6. Because of this, staff should, from now on, also, actively work to locate influential local persons who are open and willing to support the poor to exercise their rights; the process needs these strategic allies as much as it needs joining the global people’s rights movement (e.g., the People’s Health Movement secretariat@phmovement.org).
7. To make sure that the needed learning happens, ‘learning goals’ must be established and progress tracked; mistakes have to be critically and collectively analyzed; a constant check that what is being applied is congruent with the core principles of universal HR also needs to be assured; adaptations to local contexts are OK, but principles are never to be compromised.
8. All the above has to lead to a reprioritization of civil society organizations’ work. A deeper engagement with local contexts is now needed, one that puts them in touch with the basic causes of poverty and injustice - even at the cost of taking risks when responding to conditions on the ground. Their goals have to be clear and transparent in all debates and their messages consistent with a strong identity with the RBA. They simply have to behave differently, calling for changes in the interplay of deep-seated forces that are resulting in local situations detrimental to the rights of the poor and the marginalized. On all these, civil society has to take a public stand.
9. Civil society has to be prepared to sometime say ‘no’ to donors and to engage the latter on the new RBA. For this, only creating alliances and networks with like-minded change agents and organizations will give the needed clout for joint strategic action.
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Mostly taken from Promoting Rights and Responsibilities Newsletter, September 2003, CARE International.
Food for a thought not-committed to
1. The World Bank has a Human Rights problem: it does not respect them enough; a pity, because it should harness the inspirational power human rights (HR) bring with them and thus rekindle the HR hopes of literally billions of people. (S. Ebadi, editorial page, International Herald Tribune, 17/6/2004) The Bank also disregards the central issue of income-distribution and does not adhere to the-principles-of-sustainable-development. It still seems to believe that technological progress somehow automatically leads to a more effective use of the huge resources it invests. [This, perhaps because most of its analyses cover the short term?] (N. Michaelis, D+C 31:4, April 2004, pp.162-163) Ideologically motivated, it believes that to promote growth, to privatize, to deregulate and to liberalize are necessary.
2. Bottom line: For the International Financial Institutions (IFIs) (of which the Bank is one), what remains an uncontestable truth is that discrepancies clearly persist between their vision, their pronouncements and the realities on the ground.
3. On the other hand, the IMF (the IFI par-excellence) never pays much attention to income-taxes and property-taxes and to the need-to-combat-tax-evasion; it focuses too heavily on cutting-public-employment or capping-public-sector-wages; furthermore, having resorted to apply excessively-detailed-conditionality has clearly not been effective. The IMF’s tight policies have rather promoted ‘salvation through suffering’ - and this is not very much in the spirit of human (people’s) rights... [All this, the careful reader can find recognized in F&D, the Journal of the IMF itself, e.g., 41:1, March 2004, pp.43, 44, 49].
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Food for a masked thought
1. One-is-what-one-is as long as the disguise lasts. Dropping the mask of the disguise is an act of reivindication of our liberty, or an avenue for its exercise and, at the same time, a denunciation of the so many lies we tell ourselves to continue living at peace with ourselves.
2. What one finds behind one’s own mask is always another mask - but the mask is you. These masks are the result of what they taught you to love and reject and that what you now really consciously or subconsciously love and reject. You use those masks, because you need them to live. Our lives are a complex and refined system of masking ourselves and pretending; wouldn’t you agree?
3. But as persons obedient of both the laws-of-physics and the civic-laws-of-the-places-where-we-live, we cannot at the same time be the ones who think we are righting-the-wrong and the ones who naively or perversely ‘right-the-actions-of-the-wolves’ in the places where we do not live. We cannot continue to defy the-apparent, and not the-real order of the world. [Truth is not just solely what fits inside ‘our-small-Chinese-shoe-of-what-we-consider-rational’]. Whatever realism we adopt does not allow us to escape the grim social realities of the world that surrounds us. What we see there, requires we crumble the static mentality that sustains the prevailing social order in what has become a mirage of progress, or progress without a capital P (or what some have called ‘an ironization of charity’).
4. Years pass by and the worthy causes and good hopes die; forgetfulness (‘the-conspiracy-of-forgetfulness’) then becomes a necessary medicine to allow us to live in peace with ourselves and survive. Therefore, the only thing for which I have a deadly contempt is forgetting.
5. Arbitrary epilogue: So, speak up (and act) on HR we must - spilling out the-adrenalin-of-creative-anger we so seldom spill. [Or, is it true we live in a fear-of-desire-of-seeing-happen-what-we-so-much-hope-for?] ...Never leave to think tomorrow what you can say today... (G. Cabrera Infante)
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Adapted from Jose Donoso, El Lugar Sin Limites, Catedra, Letras Hispanicas, Madrid, 2002.
Food for a globalized thought
1. Globalization confuses the Rights-of-Liberty of persons
(i.e., non-interference by the state in issues of the persons) with the
Rights-of-Corporations who insistently claim for non-interference by
government.
Human Rights (HR) work primarily focuses on the groups
socially excluded from the prosperity some have long gained (and continue to
gain) from Globalization (or from any previous stage of Capitalism). Therefore,
HR work focuses equally on Rights-of-Justice (as on Rights-of-Liberty)
denouncing, where needed, state regulations and actions that interfere with
ensuring/guaranteeing equity and fair distribution-of and access-to social,
economic and cultural benefits.
2. In today’s globalized world, minority-power-holders (often important duty-bearers) put in place political distortions to consolidate their oppressive and exploitative power. We need to understand why those forms of power have been accepted and are deemed-bearable-by-the-people-who-suffer-under-them. The French philosopher Michel Foucault was of he opinion that the real scandal is not ‘power abuse’, but ‘obedience abuse’: the real problem is not the base of power, the real problem is one of docility. [It is always useful to look at the other side of the coin, isn’t it? - some more food for thought here on what to do about this.]
3. In a world globalized or not, a Need is much more than a Want. A need, if not satisfied, causes damage, for example, the-non-satisfaction-of-basic-needs eventually leads to social and/or biological death. That is why, in many of us, basic needs (have) generate(d) the desire or the moral imperative (but not the obligation!) to do something to satisfy them. (C. Sepulveda)
4. Furthermore, a Right is much more than a Need. It carries with it a legally binding obligation for redress (i.e., ‘correlative duties’). Countries that have signed and ratified the different HR covenants have, in fact, signed social contracts to respect, protect and fulfill the human (people’s) rights enshrined in them.
5. This notion of a social contract allows us to be very clear: We are never going to achieve our HR goals by stepping up the lobbying of NGOs or by promoting ever stricter conditionalities in foreign aid (ODA) only. [For many reasons, PRSPs will not do either. Just a key example: PRSPS do not address the disadvantaged position of poor countries in the world trading system].
6. Progress in HR work will depend on mobilizing claim holders, opening opportunities in ways that will inspire them to think in new ways and to take action themselves. (R. Jolly) New strategies also require the wisdom to focus, to persevere in carrying out consistent and determined action plus the ability to secure sufficient amounts of the (right) needed resources. The idea is not to overburden the system with a high diversity-of and with fragmented actions that blur the focus on our primarily HR-based work. [In a spider web metaphor, each string represents a different cause-and-effect-relationship. If one or even a few threads are damaged, the firmness of the web is still intact. Increasing the number of damaged threads threatens the strengths of the web until, suddenly, the web collapses. If we want to repair a-not-yet-collapsed-but-seriously-damaged web, we do not need to replace all its threads, but rather identify the most important ones to replace, as long as the replacement threads are strategically placed and are strong enough]. (R. Gross) Or put in another way, the task is not to deliver excuses, but to get the job done (G. Kent).
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Food for a thought to be enshrined in law
Objectives for a national action plan (mostly for duty-bearers at different levels, but also for claim-holders)
1. Explicit recognition of the Right-to-Health-Care to be enjoyed by all citizens. (Recognised by all concerned parties, i.e., central and provincial governments, HR commission, civil society, citizenry and all health sector staff.
2. Definition of an Essential-Health-Services-and-Supplies-Package whose timely and full delivery is to be assured as a right at the different levels of the public health system.
3. Definition of the Citizens’-Health-Rights-related-to-the-private-health-sector including a Charter-of-Patients’-Rights.
4. Legal enshrinement of the Right-to-Health-Care by enacting a Health Services Act, that includes Public-Health-Services-Rules and Clinical-Establishment-Regulations to regulate both the public and private health sector.
5. Operationalisation of the Right-to-Health-Care by formulating a broad timetable of activities by central and provincial governments consisting of the essential steps required to ensure availability of and access to quality health services by all citizens (this, necessary to operationalise the Right to Health Care). [This may include a basic set of Health Sector Reform measures indispensable for a universal and equitable access to quality health care, and guidelines regarding the budgetary provisions to be made available for their effective operationalisation].
6. Institutionalistion of mechanisms-for-joint-monitoring at district, provincial and national levels involving Health Departments and civil society representatives and including the specifics on regularity of monitoring activities and of the powers of monitoring committees. [In parallel with this, an institutionalised space needs to be created for regular civil society inputs towards a more consultative planning process; measures taken should also be combined with vigilance mechanisms to take prompt action regarding, for example, illegal charging of patients, unauthorized private practice, corruption relating to drugs and supplies].
7. Enforceable-redressal-mechanisms to be put in place at district, provincial and national levels to address all complaints of denial-of or abuses-in the provision of health care.
(contd)
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Adapted from National Public Hearing on the Right to Health Care organised by the National Human Right Commission & JSA (PHM India) in New Delhi, 16-17 December 2004. (courtesy of Abhay Shukla at CEHAT, Mumbai).
Food for a thought to be enshrined in law (2)
Specific actions under the Action Plan
A. Government and Ministry of Health actions (as prime duty- bearers):
A1. Enactment of a National-Public-Health-Services-Act that recognizes and delineates the Health Rights of citizens (claim holders), the duties of the Public health system, the public health obligations of private health care providers (duty bearers) and the specifying broad legal and organisational mechanisms to operationalise these rights. [The Act is to make the actions under this Action Plan mandatory, and is to make more accountable/justiciable the denial of health care. It will also include special sections recognising and legally protecting the health rights of various sectors of the population with special health needs, i.e., women, children, persons affected by HIV-AIDS, persons with mental health problems, disabled persons, persons in conflict situations, persons facing displacement, workers in various hazardous occupations including unorganised and migrant workers].
A2. Definition of packages-of-essential-health-services at different levels (village/dispensary/community health center/district and provincial hospital) to be made public to all citizens as their right.
A3. Substantial increase-in-central-budgetary-provisions-for-public-health [to be increased to 2-3% of the GDP in the next three to four years].
A4. Setting up a Central-Council-on-the-Right-to-Health to develop a consensus among various state agencies and civil society towards operationalising the Right to Health Care across the country.
A5. Enacting a National-Clinical-Establishments-Regulation-Act that ensures citizen’s health rights concerning the private health sector and includes the right to emergency services, as well as ensuring minimum quality of care standards, adherence to standard treatment protocols and ceilings on diagnostic tests and essential health services prices.
A6. Issuing of a Health-Services-and-Drugs-Price-Control-Order, as well as the formulation of a Charter-of-Patients-Rights.
A7. Setting up a Health-Services-Regulatory-Authority that will broadly define and sanction what constitutes rational and ethical practice, as well as set and monitor quality standards and prices of services. [This is not to be a representative body of doctors alone, but is to include representatives of health care providers, public health experts, legal experts, representatives of consumers, health and human rights groups and elected public representatives].
A8. Issuing of National-Operational-Guidelines-on-Essential-Drugs that specify: a) the right of all citizens to access good quality essential drugs at all levels in the public and private health system; b) the promotion of generic drugs over brand name drugs; c) the inclusion of all essential drugs under the Drug Price Control Order; and, d) the elimination of irrational formulations and combinations. [The Government is also to take steps to publish and consolidate a National Drug Formulary based on the morbidity pattern of the people in the country].
A9. Taking measures to integrate-national-health-programmes-with-the-Primary-Health-Care-system in a way that decentralizes planning, decision-making and implementation. [Focus to be shifted from bio-medical and individual-based measures to social-, ecological- and community-based measures that will, among other, include the compulsory health impact assessment of all development projects, as well as a decentralized and effective compulsory surveillance system of notification of prevalent diseases by all health care providers, including private practitioners].
A10. Reversal of all coercive-population-control-measures that violate basic human rights, are not effective in stabilising population, and draw away significant resources and energies of the health system from public health priorities. [Steps to be taken to eliminate and prevent all forms of coercive population control measures which target the most vulnerable and marginalized sectors of society].
A11. Setting up by the Ministry of Health of a-functioning-national-mechanism-of-health-services-monitoring that periodically reviews the implementation of health rights and the respective underlying structural and policy issues responsible for health rights violations. [Health sector civil society organizations to be involved].
(contd)
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Adapted from National Public Hearing on the Right to Health Care organised by the National Human Right Commission & JSA (PHM India) in New Delhi, 16-17 December 2004. (courtesy of Abhay Shukla at CEHAT, Mumbai).
Food for a thought to be enshrined in law (3)
Specific actions under the Action Plan
A. Government and Ministry of Health actions (contd):
A12. Preparation of a National-Accident-Policy with the establishment of appropriate accident and trauma services in all district government and private hospitals.
A13. Taking concrete steps to eliminate-spurious-drugs-and-sub-standard-medical-devices.
A14. Assuring-universal-access-to-mental-health-care.
A15. Enactment of a Public-Health-Protection-Act that defines the norms for nutritional security, drinking water quality, sanitary facilities and other key underlying determinants of health. [Such an act will complement the existing acts regarding environmental protection and working conditions to ensure that citizens enjoy the full range of conditions necessary for the preservation of health, along with the right to access good quality health services].
A16. Instituting a Health-Rights-Redressal-Mechanism at national and provincial level to investigate and take action in a timely manner in cases of denial of health care.
A17. Introduction of a set of Health-Sector-Reform-measures that will ensure the health rights of all through the strengthening of public health systems, and by making private care more accountable and equitable. [The minimum aspects of a Health Sector Reform framework that will strengthen public health systems must be laid down as an essential precondition to securing health rights of all and must include provisions to guarantee free health care to those who cannot afford it].
A18. Taking the necessary steps to effectively-decentralize-health-services-management [both in terms of decision-making and of decentralized budgets].
A19. Ensuring full-availability-of-essential-drugs in the public health system with transparent drug procurement and efficient drug distribution procedures and adequate budgetary outlays. The new drug policy should also promote fair drug prices and their rational use in the private sector. [Copies of the drug formulary and prices will be displayed in all government facilities and (with an approved mark-up) in private health facilities. Regular updating of the formulary should be ensured and mechanisms be set up for users to table complaints].
A20. Development and wide distribution of treatment-protocols-for-common-diseases to health professionals in the public and private sectors.
A21. Adoption of a nationwide-community-health-worker programme with adequate provisioning and support, so as to reach out to the most marginalised rural and urban areas, providing basic primary care and strengthening community level mechanisms for preventive, promotive and curative care.
A22. Adoption of a detailed essential-secondary-care-services-plan that includes emergency care services.
A23. Public-identification/notification-of-medically-underserved-areas together with ad-hoc-plans-to-close-these-gaps in a time bound manner.
A24. Adoption of an integrated-human-resource-development-plan to ensure adequate availability of health humanpower including the most peripheral levels.
A25. Adoption of transparent-non-discriminatory-health-workforce-management-policies, especially on transfers and postings, so that health personnel are fairly treated when working in rural areas, and so that specialists are sent to serve in secondary care facilities according to public interest.
A26. Adoption of improved-vigilance-mechanisms to respond to and limit corruption, negligence and different forms of harassment within both the public and private health systems.
A27. Implementing relevant actions-on-food-and-nutrition-security, nutrition-surveillance, early-childhood-development-and-school-feeding-programmes to address food and nutrition insecurity and malnutrition, which are a major cause of ill-health.
All the above will be taken as a base minimum by provincial governments, and modified to match the specific health situation in each province. To this effect, these governments will also increase their health budget over the next three to four years to levels needed to respect the right to health care of its citizens. Corresponding monitoring mechanisms with civil society involvement will be set up in all districts to monitor rural health services, as well as in towns and cities to monitor urban health services.
B. National Human Rights Commission actions (if none exists yet, setting one up is in-itself a priority for civil society)
Both as a duty-bearer and as a conduit for claim-holders, the NHRC will:
B1. Oversee the monitoring of health rights at the national level by initiating and facilitating proactive monitoring activities and by appointing Special Rapporteurs on Health Rights in each province.
B2. Review all laws/statutes relating to public health from a human rights perspective to make appropriate recommendations for the Government to make commensurate, human rights-compliant amendments.
B3. Oversee the implementation of redressal measures being implemented in a timely manner.
C. Civil society organizations actions (mostly as a conduit of claim-holders)
C1. Work for the widest possible awareness-raising on health rights as set out in this Action Plan and work on an empowering ‘health rights literacy’ with all sectors of health rights claim holders of the country - especially the currently more marginalized.
C2. Act as a watchdog on the progressive implementation of the elements of this Action Plan and denounce all procrastination by the respective duty bearers in this respect.
Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Adapted from National Public Hearing on the Right to Health Care organised by the National Human Right Commission & JSA (PHM India) in New Delhi, 16-17 December 2004. (courtesy of Abhay Shukla at CEHAT, Mumbai).
(SCROLL ON: CONTINUED UP TO READER No. 211, MARCH 2009)
