Health care as if people mattered
Photo: Sunil Mehra
In recent years medicine and medical technology have become major growth industries. And the humanitarian pronouncement of Florence Nightingale, 'Health is not only to be well, but to be able to use well every power we have to use' seems to have been lost in the metallic jungle and clamour of modern hospitals, where human beings become part of electronic circuitry. The contradiction within modern medicine is shown by the major and expensive developments taking place in medical technology (body scanners, heart transplants), while about 800 million people in the less developed parts of the world continue to have little or no access to any health care services.
One of the greatest challenges to humanity must be to find alternatives that will provide simple medical care to the great majority. This requires a change of direction, a new ideology and often a new set of tools.
The task of the Appropriate Health Resources and Technologies Action Group (AHRTAG) is to find worthwhile alternatives, either in hardware (technologies, equipment) or in software (education, administrative systems), so that the benefits of today's medical advances can reach a larger proportion of people in the world.
AHRTAG, with its origins within the Intermediate Technology Development Group has inherited the spirit of 'Small is Beautiful' and an ideology, 'health care as if people mattered'. It shifts the focus of health care from institutions to people - the community, the mother and the child.
The appropriate technology approach applied to health care means devising a flexible system, capable of adapting to individual skills, varying levels of knowledge and education, disparate resources and a wide range of supportive technologies.
*Relevant Health Care*
A major part of AHRTAG's work is the collection and dissemination of information on health care relevant to the Third World. It maintains a specialised library on health care in the Third World and offers an enquiry service to health personnel associated with these areas. The organisation is also involved in the training of appropriate health care personnel like auxiliaries and community health workers. The other activities include development of educational materials for community-level health personnel and the sharing of information about programmes and experiences from all over the world through a bibliography "Auxiliaries in Primary Health Care".
Preventative medicine is the foundation of good community health care. Immunization plays an important role in the prevention of many infectious diseases. Vaccines are very delicate compounds, and the efforts of an immunization programme can be totally destroyed by their mishandling. For this reason, a new combination of techniques and equipment has been devised to promote the correct storage and distribution of vaccines in hot climates. Malnutrition, besides being a serious condition in itself, reduces resistance to infectious diseases and often leads to death in young children. The easiest and most useful measurement to indicate malnutrition is the infant's weight. Balances for weighing children are mostly too expensive for communities to afford. And so AHRTAG had designed simple weighing scales which can be made using locally available labour and materials, at a fraction of the cost of imported scales, but just as effective.
Appropriate health technology has sometimes been accused of promoting standards in the Third World which would be unacceptable in a developed country. But despite their emphasis on high technology medicine, many industrialized countries today are also training and using a wide variety of health auxiliaries. Regardless of the degree of industrialization and the ability to pay for sophisticated medical technologies, all medical care should be subject to tough criticism. For only then can we establish the most effective alternatives to present systems which offer so much to the few and precious little to the majority .
Appropriate Health Resources & Technologies Action Group (AHRTAG-UK)
85 Marylebone High Street London
Churches fight for Forgotten Refugees
by Murray MacAdam
The Western media have been in a tizzy for months now ever since the Cambodians started fleeing to Thailand. Refugees are hot copy; at least refugees from Communist governments. Yet refugees from iron-fisted, military regimes elsewhere - in Latin America for example - continue to go almost unnoticed.
That's a condition which the Canadian Inter-Church Committee on Human Rights in Latin America (ICCHRLA) wants to remedy.
'Our work is to show that human rights violations exist (torture, imprisonment and death) and that they result from specific economic and political power struggles,' says committee worker Fran Arbour. 'We try to educate people here in Canada and to mobilize them in support of Latin Americans fighting for their rights.'
The ICCHRLA grew out of an ad hoc inter-church group formed after the military coup in Chile of September 1973. That group brought Canadian church people together to urge the government to allow Chilean refugees into Canada and to help the Chileans once they arrived. The group also tried to alert Canadians to the violent suppression of civil and political rights in Chile.
In 1976 it was clear Chile was not the only South American country trampling on human rights. Refugees from Chile and Uruguay temporarily stranded in Argentina had to leave that country after a military coup. Torture and arbitary imprisonment continued in Brazil so the Committee expanded its mandate to include Argentina, Uruguay and Brazil, and took on its present name.
As its reputation grew other Latin Americans began writing to the Committee with stories of political terror and human suffering. The Committee again expanded its work to El Salvador, Guatemala, Nicaragua and Peru.
Liason with Canadian external affairs and immigration departments is important. 'We try to improve Canadian policy towards Latin America by informing the government of conditions it might not be aware of or that it might be ignoring,' says Ms Arbour.
'Church networks are often far more in touch with local conditions than Canadian diplomatic posts overseas', points out the Committee's Chairman, George Cram. 'Because the government knows we are connected and accurately informed, we can help keep the government on its toes.
We try to give the people of Latin America a voice in Canada - we act as a proxy.'
The 18-member committee includes representatives from each of the national churches and Canadian religious groups that support it.
Improving the process by which refugee status is determined is a major Committee goal. In response to the plight of 13 refugee claimants threatened with deportation the Committee, along with other organisations, met former Immigration Minister Bud Cullen to press for changes in Canada's refugee policy.
The government agreed to help refugee claimants learn how to obtain competent legal counsel and that claimants should know why they've been granted or refused refugee status.
The Committee is lobbying to change what it sees as a completely unjust refugee policy. Mr. Cram notes; 'We choose out of self-interest. We don't select on refugee criteria, but on labour market needs. Thus we reject anyone with a handicapped child and refer those without large families.'
Canadians may wonder whether protesting human rights violations to bullying governments has any effect. Yet solidarity action shows oppressed people that they are not fighting alone.
'The people in the Churches overseas recognise that the Canadian Churches are concerned about their problems,' says George Cram. 'it really is a great strength to Latin American church people as they put their lives on the line daily battling on those crucial human rights questions. It gives them the resolve to go on.'
For further information: ICCHRLA,
40 St. Clair Avenue East, Suite 201,
Toronto, Ontario M4T 1M9
Beware the Anti-Reports
by Peter Marshall
Black South Africa explodes and a few carefully chosen white journalists report. Rio Tinto presents its annual report but the blood has been wiped off the figures. The Queen waves serenely to the adoring masses as her appointed agents pick their pockets for the pleasure. Nuclear reactors melt down while the authorities seal mouths for reasons of security. Women are legally equal and then return to their traditional chores. The Counter Information Services want to know how and why this happens.
The CIS is a collective of committed journalists who publish information not covered or collated by the established media. It is their stated aim 'to investigate the major social and economic institutions that govern our daily lives in order that the basic facts and assumptions behind them be as widely known as possible'. In practice they tend to focus on the role of corporations and governments and the discrepancy between what they say and what they do.
Their stance is uncompromisingly 'counter' the ruling powers and they emphasize their alternative sources of information by calling their findings 'Anti-Reports'. They by-pass official spokesmen and gather their material from those directly involved on the inside - from the shop-floor workers in Fords to the inhabitants of Soweto. The result is a well-researched, lively, and graphic collection of articles on a particular subject. While some of the facts may date, the perspective remains invaluable. And they try to follow issues up and keep those involved informed of new developments.
The most recent reports of the CIS have been on The New Technology and on the Sell Out in Zimbabwe. The first looks at the enormous effect the micro-electronic revolution will probably have on the place of work in our lives. There is an analysis of the attitudes of the British government and the trade unions, the activities of the multinationals, and the particular problems of the Post Office and printing industry. While the new technology could create more leisure and freedom, the report points out that as long as those who control industry are concerned with profits rather than the quality of life, it will probably mean more work discipline, more boredom, and more unemployment.
The report on Zimbabwe was planned to coincide with the London Conference. It studies the reality of white power behind the black faces in the Salisbury regime, the state of the war, the interests of British politicians in the country, and the activities of the pro-Rhodesian lobby in Britain. The role of the Western arms industry and of British companies is explained. The authors give a diplomatic history leading up to the present sell-out and conclude: 'as the Rhodesian armed forces are re-equipped with the weapons of death, crocodile tears are shed by Western politicians and the mountain of corpses is used as justification for further diplomatic machinations . . .'
So long as Fleet Street remains controlled by business interests and the radio and television practise a self-imposed censorship, organizations like the C I S perform an essential role in keeping the public informed.
For further information contact:
Counter Information Service 9 Poland Street
Cleaning up the Marketplace
by Robin Osborne
Illustration by Jenny Cooper
In Sydney recently William Bernbach, one of the most influential figures in post-war American advertising, said that 85 per cent of adverts are not read. The co-founder of the Doyle Dane Bernbach agency added that no industry was more wasteful than advertising. But despite such enormous wastage a good deal of ad expenditure does hit right on target (as they say) and results in increased sales for clients' products.
In the ideal market that manufacturers claim exists, this should not be a problem. Isn't industry geared to producing goods to meet an existing demand, with promotion only encouraging changes in brand allegiance?
In theory yes, but in practise certainly not. Humankind was not born with an inherent desire for, say, aerosol spray that adds lustre to the leaves of indoor plants. And how could positively harmful products (the classical example being cigarettes) find a place in the market at all?
At least the US has a group of watchdog bodies which, despite a degree of muzzling, can still bare their teeth when a real challenge arises. In Australia, alas, this is less so. To fill this gap a group of concerned (and informed) Australians have now formed a watchdog organization of their own: MOP UP. It is an appropriate acronym for the Movement Opposed to the Promotion of Unhealthy Products.
Founder-member Simon Chapman of Sydney University explained that MOP UP began as a result of the general disillusionment with existing protest strategies.
'Every meeting aimed at banning, say, cigarette advertising, would end up with a petition to the Minister of Health, and the predictable result of that - namely no action at all because of the strength of the tobacco lobby.'
Since its inception in July MOP UP has concentrated on some of the advertisers' weak points, particularly the industry's so-called voluntary code of ethics.
These are easy to infringe without prosecution. For example the written aspects of drug advertising are controlled, but not the visual. The letter of the law can be obeyed while the spirit is abused.
The tobacco industry is a regular offender. With cigarette promotion now banned from television the industry has switched its offensive to sports sponsorship. The current promotional budget in Australia is between A$6 - 10 million annually.
MOP UP's response has been to run its own ad campaign featuring a signature list of prominent people, especially those in sports.
Simon Chapman feels that it is important to 'run the argument at a certain mythic level: the forces of good against those of evil; the forces of those who care about health and kids' futures, against the idea of corporate profit'.
Some MOP UP members feel that the group is being tactically, naive and favour more radical action. One of these, Bill Snow, a Sydney-sider renowned for jail sentences associated with the defiling of public billboards, insists that a paper war against the powers-that-be is a waste of time.
Snow's strategy is the spray-canning of anti-smoking graffiti on posters, although this approach is not endorsed by MOP UP - if for no other reason than the lack of funds to pay fines or the time to serve jail terms.
Although MOP UP is still promoters of unhealthy products are already worried. From a 'deep throat' in the tobacco industry Simon Chapman has heard that a number of high-level meetings have been held to discuss ways to combat the threat.
MOP UP's latest plan is an annual set of advertising awards highlighting the Worst Campaigns of the Year.
Movement Opposed to the Promotion of Unhealthy Products, MOP UP., P.O. Box 112, Kensington, N.S.W., Australia 2033.
MOP UP has tried to counter ads like this one with its own campaign.