issue 166 - December 1986
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Doctors, pharmacists, politicians and the pharmaceutical industry are rightly criticized in NI 165, which catalogues the plight of patients in the Third World and reveals how inappropriate prescribing and improper deals have undermined health provision. Such practices must be exposed. I am writing, however, to stress the need to reverse the crisis, to restore confidence and build health services that provide for patient welfare rather personal (or company) profit.
Pharmaceutical profiteering is worldwide and all the misdemeanours described for the Third World have been (or are being) committed in industrial countries. Despite this, much has already been achieved in the detection, exposure, control and elimination of such activity. This has been managed by a few individuals with the sympathy and the support of the public at large.
Underhand practices in health provision thrive on dishonesty and so it should be possible to combat them with firm, reliable and impartial information. Such information is cheap compared with the cost of inappropriate medicines or the price in lives resulting from the abuse of medical practice.
Dr Joseph Collier
Clinical Pharmacologist, St George's Hospital
University of London, UK
Perhaps because of its similarity to the more straightforward babymilk campaign, campaigning on medical drugs has been beset by oversimplification. So the range and style of articles in NI 165 is welcome.
The most urgent priority for Health Action International in the next five years will be to build up a strong network of national campaigners and lobbyists to argue for essential drugs policies, most urgently in developing countries. Without good policies and the political will to implement them, the ideal of equitable and safe use of drugs will fail. Since 1978 many hopes have been pinned on the strategy of primary health care - but without adequate supplies of essential drugs, paramedical workers will be unable to win the confidence of their communities.
Health Action International
The Hague, Holland
How saddening to read, in your otherwise excellent issue on Children's Rights (NI 164), Amanda Root's article castigating governments for bringing in the sort of progressive, supportive measures which socialists have advocated for many years.
To be a socialist is to be a feminist. It seems the converse is not always true. To some, feminism is all. To them a woman's right to choose means one choice - abortion. Anything which encourages her to choose motherhood is resented and attacked.
Such is their paranoia that even the introduction of labour-saving devices into the home is seen, not as a welcome way to relieve women of tedious drudgery, but rather as a plot to keep them sweating over a hot microwave oven. What ulterior motive would they project upon a man devious enough to help with the chores - or even change nappies?
Amanda Root replies: Pronatalist policies are not intended to increase women's powers of choice: they are designed to tailor those choices to suit the needs of various nations' policy-makers.
I am not against motherhood, but I am opposed to the unfair burden it places on women. Men are free to choose whether or not they take up the responsibilities of parenthood or help with household chores. Most women don't have this choice.
We would like to congratulate Wayne Ellwood, for his deeply moving article (NI 163). As with so many magazines covering the subject of parenting, we had assumed that the reasons for wanting children at all might be taken for granted and the emotions of infertile couples at best by-passed or at worst dismissed as self-indulgent. We were wrong - in speaking of his pain, joy and motivation as a parent, Wayne has surely spoken for us all.
Lynda and Andy Gilbert
I read with some despair the letter from Alison Hill on what she termed the 'pro-apartheid policies' of Co-op supermarkets (NI 164). Your editorial comment was also misleading. The facts are that the CWS, which is the wholesaling organisation, and CRS Ltd, which is the largest retailing society, both have an absolute ban on South African produce - as do many smaller independent Co-operative Societies. Obviously the particular society in Bradford does not have such a policy.
I have two pieces of advice for those in Bradford. First, keep shopping at the Co-op. Second, join the Society in that area and combine with other members to change the policy at the Annual Meeting.
The vast majority of Co-operative stores do not stock South African produce, but that has been the result of years of pressure and campaigning by individuals and organisations like the National Federation of Progressive Co-operators.
Co-operative Wholesale Society,
I am replying in particular to the piece by Ameen Akhalwaya (NI 163) and to all the other Third World intellectuals who lambast us Westerners for not caring about world peace and for implying that our protests against nuclear weapons are motivated by self-interest.
When Pakistan made its first nuclear bomb the majority in the country, were, unlike Western peoples, neither opposed nor indifferent to that achievement. On the contrary they were positively overjoyed with nationalistic pride and belligerence. I suspect that the reaction would be the same by most peoples in other Third World countries, no matter how poor, with the attainment of this ultimate status symbol.
We Westerners do care about world peace - just let us carry on protesting and trying to change our governments in our own way. Meanwhile all you Third World activists could cease trading on Western guilt and concentrate on dismantling your traditional systems of corruption and despotism so that when Western aid does flow in your direction it is neither frittered away on weaponry nor used to fill the pockets of the already rich.
The argument in Beyond the cross of iron (NI 163) that military spending is bad for a wealthy nation's economy shows lack of insight The wealthier a person, or a country is, the greater the need that is felt for self-protection.
In alluding to mortgage rates, John Wiseman is not just appealing to self-interest in general, but to a form of it which has grown to be a root cause of the problem: greed. If there is any solution to the arms build-up it will not be found by greater desire for wealth.
Not South Africa
I read with interest that you will now refer to New Zealand as Aotearoa (NI 163). With this in mind why do you still refer to South Africa and not Azania? All sane people hope to see Azania appear on the map of the world in the future (the sooner the better).
Azania is the country-name adopted by the Black Consciousness Movement and the Pan-Africanist Congress. It is opposed by other forces in the liberation movement such as the African National Congress and the United Democratic Front. If a name was agreed by all these groups, we would doubtless start using it.
Your ideas on the 'position of women' section in the Country Profile (NI 163) don't tally with mine. If you think women's position in Jordan is 'Poor' (as I expect it is) and you say 'limited to traditional roles, except in the middle classes' then how would you define women's position here in the UK? Who decides how many 'stars' these 'At a glance' categories receive, anyway?
Ed. note: The 'position of women' is arrived at by the writer from their research into women's life expectancy and other facts, blended with the opinion of women - the country and their own impression.
I have yet to see any worthwhile estimate of what sanctions against South Africa might achieve other than hardening attitudes, increasing poverty, and accelerating armed conflict. Even if this does overthrow the present Government and its wicked system, will the aftermath benefit the lives of the poor black African? I have seen at first hand the results of civil war in Africa - grenade wounds, high velocity missile wounds, napalm smouldering on children; I am a surgeon. Nothing surely can justify this in the South African crisis.
Sanctions will remain an ugly gesture, since experience shows, and common sense suggests, that they cannot be made to work - however strict the efforts to apply them. Please provide a rational background to all possible measures which might be employed to abolish apartheid.
P M Weston
The civil war and bloodshed you speak of is already taking place. Sanctions are one of the only means available to the West (short of raising an international army) of reducing the length of that bloodshed.
The views expressed in these letters are not necessarily those of the New Internationalist
Margaret St Clare has been living and working in the Zimbabwean
The building of my house is teaching me new lessons. The housebuilder is the kraalhead's son Talenda (Thank You) assisted by three young men, two of whom are brothers and live nearby. The thatcher lives 15 minutes walk away. Besides indicating the wealth of useful skills locally available this closeness has a significance I didn't appreciate at first - so I made a mistake over the water carriers.
One morning last week a forceful woman in green from outside the village arrived at my door and suggested that she, her daughter and mother-in-law would carry my water. The next morning we sat in the round kitchen hut - the three women, the builder, his assistants and I - to thrash out rates.
At first no-one would come forward. The woman in green wanted me to set a daily amount, I said they should give me a fair suggestion. Worried that I had no idea how much water we'd need or how long carrying it might take, I asked Talenda to help me calculate what the builders would need and hurriedly consulted my labour budget Then I cheerfully agreed to pay five dollars a drum.
The following morning, the first day of building, I was five miles from here cycling down the mountainside to visit a co-operative bakery when the kraalhead's wife of that area hailed me. 'It pained my heart to hear of that five dollars' she said gravely. 'You see this building here? That river over there? Two dollars per drum was the amount they earned.'
'It doesn't matter,' I answered, annoyed.
'We don't want that "it doesn't matter" ',she said, as I got back on my bike, thinking if I can afford to let these women have a bit over the odds, what does it have to do with everyone else?
It hit me almost immediately, with a sinking feeling, how my first reaction was wrong. Wage rates are not a private affair - I had acted hastily, without a full grasp of the situation. Why hadn't Talenda stopped me? Ashamed, I pedalled on to work.
That evening Talenda called in to tell me how the building had progressed. Two drums had been filled in by ten o'clock and the foundation was in place. Everything was fine. 'What,' I ventured, 'about the inflated water rates?' His face clouded. 'Ah! That old woman - we did not know; she is dangerous. If she is there, she can make it so I put my hand on this brick and it will never come off! We should pay them tomorrow for the work done, and tell them we are waiting for some more materials to be delivered. Then we find people here who want to do the work for the usual rate. Ah! Five dollars a drum is too much.'
Relieved and amused as we both were, I felt that the charge of witchcraft was a graphic way of expressing two resentments. First, that I had taken on 'strangers' when neighbours were keen to be employed; secondly, that I was paying these strangers almost as much for a couple of hours work as the men were getting for a full day!
Again, I am reminded that everything here is connected. A supposedly 'supernatural' explanation may be a substitute or metaphor for another very practical one. It is not hard to see why, quite apart from prejudice and sentiment, people prefer to employ neighbours and relatives living close by than mabrakure ('you've come from far' - an insult in Shona). For getting from place to place is a slow business which can easily be interrupted by prior commitments closer to home.
I felt these considerations myself when I chose both the builder and the thatcher against more distant contenders. Besides fostering good relations with neighbours, if the builders live nearby I know where they are. We can see each other, therefore we can trust each other. It is much harder to be reliable at a distance, when your first commitments are to those you live among.
These established and well-founded traditions of mutual support among neighbours and family often give rise to outraged cries about nepotism and tribalism in official circles. Of course these customs don't transfer well to government ministries and multinational companies. But it's important to remember that it is good to help those closest to you. It strengthens the ties of blood and neighbourhood that work for the good of the community.
The so-called 'objective' Western models of impartiality and certified merit are a necessary part of our highly stratified societies. Maybe we should look again at traditional communities and ask ourselves if Western ways of life really represent a clear improvement on them.