Claudio Schuftan MD,
People’s Health Movement, Ho Chi Minh City.
schuftan@gmail.com
Abstract:
The human rights (HR) discourse represents the return-to a greater focus and action on the basic causes of preventable deaths, ill-health and malnutrition. Commitment to change these causes coming from ethical imperatives alone does not fuel the needed social mobilization anymore. Thus agreeing on the politics of HR –beyond ethics– is the real challenge. How to operationalize this in development and in health work is what is here explored. Only a process of mobilization of beneficiaries around the issues here raised will generate forceful enough claims that stand a chance of being heeded. The HR approach thus imposes clear obligations on duty bearers that must be met –and we have to hold them accountable to it. We may not exert political leadership on these issues yet, but we cannot run away from showing intellectual leadership at least.
Key words: politics of human rights, development ethics, paradigm.
HOW DOES THE HUMAN RIGHTS-BASED APPROACH CHANGE DEVELOPMENT ETHICS AND DEVELOPMENT PRAXIS?
The vast majority of humanity just has the right to see, to hear… and to remain silent. (Eduardo Galeano)
The setting
1. The new emerging Human Rights-based approach to development work comes as a reivindication to old time activists who, for long, had been advocating and fighting for a more political approach to the ‘maldevelopment’ developing countries were subjected to during the second half of the 20th century.
2. The various mainstream Western-inspired approaches to development used during the last fifty years only weakly touched the political underpinnings of the development problematique, mainly failing to tackle it as the principal stumbling block to genuine poor people’s and countries’ development. These development models that came and went were devoid of a political vision/perspective (other than the one intentionally promoting status-quo) and simply led to a dead end alley. It took us years to figure that out.
3. In the fight for a more genuine grassroots, people-centered development paradigm, a breakthrough came in 1984. At that time, the first steps were taken to implement what later became UNICEF’s ‘Conceptual Framework of the Causes of Malnutrition’ with its different levels of causality (immediate, underlying and basic). (Jonsson, et al.1993 and UNICEF. 1990) The framework reminded us that only when those living in poverty are understood to be the most effective analysts of their own problems and agents of their own solutions, is it possible to formulate effective and sustainable interventions. (Lewis. 1999) It called on focusing more proactively on the people’s access-to and control-over the resources they need to develop and on the structural underpinnings of underdevelopment (i.e., the basic causes).
4. The increasing use of the Framework represented the acceptance of a dialectical approach that looks at the major and minor contradictions in society that result in, for example, a worldwide high prevalence of preventable ill-health and malnutrition of women and children seen as an outcome of social and political processes biased against the poor. The adoption of this approach was, therefore, a step towards further politicizing the development paradigm. It called for a dialectical unity of knowledge and action. (Schuftan. 1988)
5. For a long period thereafter, the international development community got side-tracked and concentrated mostly on individually acting on each of the underlying causes (in our example, of ill-health and malnutrition). Not surprisingly, such a shortcut approach (avoiding the politics of it all) ended up being “too timid and too narrow”. (2) (In a way, this was a comparable course to that which, in the 1980s chose reductionistic approaches to Primary Health Care that led us only half-way to ‘Health For All by the Year 2000’). Only later did the literature begin insisting that acting on each of the underlying causes was necessary, but not sufficient –that all had to be tackled at the same time. But still no voices insisting on the need to also tackle the basic causes were heard loud enough. Again, it took us years to figure that out.
6. Roughly ten years after the Conceptual Framework approach was launched, came the (complementary) ‘Human Rights-based Approach’ encompassing:
a revival of the role of the Economic, Social and Cultural Rights in development work,
a drive to explicit ‘poverty redressal objectives’ in development work making it paramount that we need to work with the poor as protagonists, and
a further bid to more concretely operationalize the newly ratified rights such as those enshrined in the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW), the Convention on the Right of the Child (CRC), the Right to Food, and the Right to Development.
The new Human Rights discourse
7. The Human Rights-based approach is in good part about the politics of enforcing (all) Human Rights. This, since Human Rights are the resurrection-of or the return-to a greater focus and action on the basic causes of the Conceptual Framework which still remain mainly unaddressed at the base of the causality pyramid.
8. In no uncertain terms, the Human Right-based approach reiterates that a relationship exists between human rights and economic and social development; and, in that relationship, it is the politics of equity that ultimately counts.
9. Orthodoxy aside, politicization is here meant to be a process that transforms anguish into anger and into the search for being ultimately relevant –keeping in mind that a political climate is something one creates, not something that is found out there.
10. In that same sense, Human Rights is about breaking the silence of powerlessness that keeps the needs and desires of poor and marginalized people from being part of national political agendas. For the disempowered to get voice is not enough; Human Rights is about getting them influence, and about the processes that lead from having voice to having influence.
11. In sum, the added value of Human Rights is that they cannot be relegated to a mere social aspiration: they are rights; even if, at present, some of them are not enforced (or enforceable yet).
When a little is not enough
12. Taking a ‘minimalist stand towards Human Rights’ will do no harm, but neither will it do much good. What you push is what you change.
13. This, because the neoliberal development paradigm has led to:
a) adopting what has been called an ‘exclusion fallacy’, where what we choose not to discuss (most often the politics of it all) what is assumed to have no bearing on the issue(s), and
b) consistently adopting soft solutions when faced with hard choices (for istance, ‘safety nets’ that are nothing but part of a strategy to manage poverty so as to attenuate social unrest, keeping it at a minimum).
14. Moreover, such exclusions and the choice of patch solutions make measurable statistics (as for instance those of the MDGs) their primary goal –not participation, not equity, not Human Rights. The stark reality is that there is no escape from politics, no way to represent the social world free of ideology.
Commitment to change coming from ethical imperatives alone does not fuel great social movements anymore. It is not enough to encourage the articulation of a shared moral vision, because it leaves us unable to consolidate this vision into moral outrage and that outrage into political power to change an unfair state of affairs impinging on the rights of people.
15. Society is said to evolve as a pendulum: a conservative cycle/a liberal cycle; action and reaction –always taking a toll of death. As long as we are trapped in this cycle and do not proactively try to break its passive successions, we cannot expect much in the way of Human Rights. As a matter of fact, remaining passive, we cannot even expect any fundamental change, except that of the awful slow variety where each step takes two generations or more.
16. Actually, both soft (ethically-motivated) and hard (politically-motivated) approaches to Human Rights are necessary. But the former alone is simply not sufficient! Both call for a profound commitment.
17. The bottom line is that there will be no more business as usual (or even business being ‘more focused’ or interventions ‘more targeted’, as the present mood seems to call for). This is thus a key time for reflection and soul searching. (Schuftan. 2006)
18. We need moral advocates to influence perceptions. Granted. We need mobilization agents and social activists to influence action. Granted. But we also need political advocates to raise political consciousness and provide leadership. The latter cannot be left for later. Therefore, since working on a common set of values is politics, agreeing on the politics of Human Rights –beyond ethical pronouncements– is the real challenge.
19. But orthodoxy (the right doctrine) is not enough either. Orthopraxis (the right acting) is ultimately more important. (A. Gramsci). The challenge is to move the process from orthodoxy to orthopraxis and from minimalist to a commensurate size course of action.
Breaking into the Human Rights paradigm
20. The use of the Human Rights-based approach to development work undoubtedly constitutes a paradigm break. But so far, this break has only been conceptual, not yet operational. In this day and age, there is a need for commitment beyond ethics. What I am convinced-of is that, in its operationalization, the new Human Rights paradigm will have to become more overtly and explicitly political with the creation of well organized claim holders’ pressure groups among those whose Human Rights are being violated. And to transcend minimalism, these groups will further have to rapidly coalesce into bigger movements –a challenge, among other, for progressive Internet sites ad lists.
21. One can confidently say that fighting for Human Rights is combating the surplus powerlessness of the have-nots by creating a movement that helps build committed, multi-level action networks.
22. We need to explode the myth that things are just fine; they are not. For this, of necessity, our strategy must become more political; that is an imperative, set by the way the world ticks. Power politics cannot just be ignored; we cannot look the other way; we have to deal with it.
23. It is not enough to go from people’s needs, to their entitlements, and from there to their rights, and then passing laws, crossing our fingers that the latter are enforced. This is considered to be a soft approach in the new paradigm.
24. We need to start from the people’s felt needs, translate those into concrete and effective demands, that bring about people’s organizations that start exercising (growing, de-facto) power, and then consolidating (their newly acquired) power with that of other like-minded similar organizations.
25. The latter delineates the needed hard approach and path, because what is needed is to counter a host of complex social and political issues that are preventing people from improving their own well-being –and these are mostly related to control processes in society.
Has science helped people’s development?
26. In the latter part of the twentieth century, Science was not deliberately at the service of people’s rights and development. The mainstream sciences –both basic and social– simply failed to raise the level of the political discourse in development work.
27. Science does provide us with the knowledge we need to implement Human Rights. But without the ethical and political imperatives to apply its principles to human development it remains toothless and idle, and overwhelmingly serves the interests of the ‘haves’.
Getting from here to there
28. Meetings on Human Rights and even the UN Secretary General’s own pronouncements, are desperately asking for ways to operationalise the new Human Rights-based approach to development.
29. As alluded earlier, the fundamental changes needed to realize universal Human Rights are not possible without conflict with the powers-that-be (those who have excess power). Thus the call for politicizing praxis in this new paradigm.
But because there is no progressive politics without the masses, only political mobilization –or ‘practical politics’, as it also has been called– will do; no matter how we will call it. Otherwise, we may have to wait for another ten years (or two generations…?) , for who knows what new breakthrough… [Actually, I do subscribe to the metaphor that “without genuine political mobilization, development is like a Christmas toy: batteries not included”].
30. We are talking here about a practical, hands-on mobilization: a mobilization for self-help actions, for lobbying, for placing demands, to fight for people’s economic, social and cultural rights, to exert active resistance to social injustice. Such a mobilization has to lead to an empowerment where popular demands are made into concrete action proposals. (Schuftan. 1990)
Human Rights in the era of Globalization
31. I am convinced the Left/Right, Capitalist/Socialist ideological divide is well-and-alive-and-kicking as the world’s political pendulum is desperately trying to regain its center after the free market ideology has been reigning supreme (and maybe go beyond…to the left?…to the right?).
32. As under Colonialism, under Globalization we live under the rule of “Might is Right” and, under the rule of that might, Human Rights just fall between the cracks…
33. Globalization does not have a human face, it leads to the recolonisation of the whole planet. The term Globalization is a euphemism for a process of domination. Power differentials are at its crux. We cannot wish it away.
34. But as opposed to people only having their Basic Needs taken care of, people having Rights makes it possible for Claim Holders to legitimately claim the same. Additionally, the Human Rights approach imposes clear obligations on Duty Bearers (i.e., officers of signatory governments) that must be met. (By definition, rights always carry concomitant correlative duties!). Such obligations include respecting, protecting and fulfilling Human Rights provisions governments agreed-to by becoming signatories of the different UN Human Rights covenants. And that is the breaking point of the new paradigm: It strengthens our hand to act politically.
35. In the development context, what this means is that states have the duty to improve the fair distribution of and access to the benefits of development. And we have to hold them accountable for it.
36. Not all forms of growth and development are Human Rights-friendly. Development has to demonstrably give protection to the most vulnerable and impoverished in society to be fully Human Rights-friendly.
37. The values we will now advocate-for under the new Human Rights paradigm are thus underpinned by International Human Rights Law that, in the future, needs to be incorporated into national laws –in part through our future political struggle for this, and through our action as watchdogs of their enforcement. Our Human Rights work should, therefore, begin at home.
38. In the Human Rights framework, the duty to fulfill the rights –of children and women, for example– does not depend on economic justifications or excuses. (Lewis. 1999)
Pleading Guilty
39. Democracy and Human Rights are interlinked and mutually supportive.
40. As development-workers-acting-as-political-activists we have to be willing to come into conflict with the ideology of the ruling minority any time it disregards Human Rights. For that to happen, we need to demystify the ideology of power-taken-as-being-neutral in the ruling development paradigm.
41. But this concept clashes with our prestige as intellectuals so far having depended on laying claim to being ‘rational and apolitical’, in short, espousing the “ideology of the extreme center”.
42. Moreover, objectively there is not yet among development workers a felt responsibility for the creation of national and international conditions favorable to the realization of Human Rights.
43. Because of that, I think most of us stand accused for our complacency towards the status-quo and violations of Human Rights, for our lack of criticism of the overall lack of progress in development, for our political naiveté (or our choice not to get involved in the politics of it all), for our uncritical pushing forward to do ‘something’ and get-things-done-and-over-with, for our paternalistic and ethnocentric approach.
In short, we cannot escape taking part of the blame.
What we have not yet done
44. The implementation of the Human Rights paradigm requires first and foremost its translation to the domestic level. Snail-pace progress in development cannot be invoked by Governments to justify the abridgment or postponement of internationally recognized Human Rights. Human Rights work will thus require committed leadership and an expanding popular commitment focused primarily on ensuring democracy, improvements in the incomes of the poorest, universal access and affordability of quality health, education and other social services, and improvements in the overall living conditions of people (especially women).
45. As a start, at the country level, we need to check on the follow-up each country has made on major recommendations from international conferences that their governments endorsed when they attended.
46. The above begs the question: How can the UN agencies and international NGOs be associated with such a hard approach without being accused of political interference? It is hoped they will evolve to higher levels of accountability on Human Rights issues carefully treading water in the political arena of each country they are active in.
47. Steps also have to be taken, then, to clarify the universal minimum core content of Human Rights to be applied in each country to avoid a lenient application of the principles of the Universal Declaration and other Human Rights covenants.
Furthermore, existing standards and policies that are not in conformity with the current Human Rights regime have to be openly opposed and contested.
Where to start?
48. In development work, dreaming is OK, but being naïf is not.
49.. On most of the issues depicted in this paper, we do not exert effective political leadership yet. But we cannot run away from showing intellectual leadership at least. All of us are called upon to help legitimize and enforce all UN-sanctioned people’s rights, and that requires a crucial change in our conceptual thinking, a change of our mindset.
50. More than before, defining Human Rights-congruent, -complying and -respecting objectives and establishing explicit Human Rights goals and benchmarks is thus a political task we cannot escape. We urgently need to contribute to the setting up of the legal entities that will define people’s rights more bindingly (e.g., setting up National Human Rights Committees).
51. To this, we will have to add all the preliminary needed work at grassroots and mass organizations level to determine the contents of what these rights are and mean in practice. This will the to be followed by the launching of the Social Mobilization and Empowerment processes needed to pursue the hard path alluded to earlier.
52. Additionally, among many other, what we need to, is to:
strengthen the capacity of development workers wherever they work to apply the human rights principles and to more effectively analyze and act upon the core economic, political and social determinants of maldevelopment with its preventable ill-health, malnutrition and preventable deaths ; (Lewis. 1999
overcome the culture of silence and apathy of this staff around Human Rights issues; this means they will have to work more directly with communities on their violated rights;
challenge and build consensus on political issues related to Human Rights of this same staff, perhaps starting with eliminating in their minds the division they see between politics and their professional endeavors;
move from the politics of status-quo to a politics of global responsibility for the enforcement of Human Rights; (the reader needs to become a scholar-practitioner-activist);
work towards the more liberatory view of social movements (a la Paulo Freire), and not waiting for opportunities, but creating them. [Rights have to be taken; they are not given!];
move from Declaration to Implementation (Gramsci); we need to “walk the talk and not talk the talk”;
link the normative standards of Human Rights with other developmental processes so as to proactively change our roles in our professional work; and
monitor the intentions and deeds of governments and donors to implement economic, social and cultural rights.
53. The overall call is for us to move from a Basic Needs to a Rights-based Approach. In it, beneficiaries are active subjects and bona-fide claim holders. In the rights-based approach duties and obligations are set for those duty bearers against whom a claim can be brought, both nationally and internationally, thus ensuring that claim holder needs are met. The added value of the rights-based approach really lies in creating and enforcing the legal accountability needed and in legitimizing the use of political means in the process of enforcing it.
54. The establishment of national and international complaints procedures is, therefore, also needed. Short of civil society taking up this function on its own shoulders, national and international monitoring bodies will be needed. One can start perhaps with eliciting contributions to the formulation and adherence to voluntary guidelines that pursue the application of Human Rights principles. More binding covenants would then have to follow.
Epilogue
55. What has been said here, is not pure rhetoric. There are some important normative messages here. I see the endeavor we are asking our peers to embark-on as the opening of the nth chapter of a long-term painful struggle on these issues that desperately attempts to horizontalize the previous more vertical dialogue on the topic. We need you to react. Here and elsewhere.
56. We are in for an exciting new era. We need all the courage we can muster. Wouldn’t you rather become a protagonist than a bystander?
57. There is a big catch up task to be undertaken to remedy past wrongs and making the next decade a winning decade for Human Rights. Never be sorry to be too late.
58. It is fitting to close with another quote from the Latinamerican writer Eduardeo Galeano who asked: What if we would start exercising the never proclaimed Right to Dream to lead us to another, possible world?
References
Jonsson, U., Ljungqvist, B. and Yambi, O. 1993. Mobilization for nutrition in
Tanzania. In Reaching Health for All,edited by J. Rohde et al, Chapter 9, Oxford University Press, Delhi.
Lewis, S. 1999. Malnutrition as a human rights violation: Implications for UN-supported programmes. SCN News, No.18, July.
Schuftan, C.1988. Multidisciplinarity, paradigms and ideology in national development work. Scand. J. of Dev. Alts. VII:2+3.
Schuftan, C. 1990. Activism to face world hunger: Exploring new needed commitments, Soc. Chge., 20:4, December.
Schuftan, C. 2006. Can significantly greater equity be achieved through targeting? An essay on poverty, equity and targeting in health and nutrition, unpublished manuscript.
UNICEF.1990. Strategy for improved nutrition of children and women in developing countries: A UNICEF Policy Review. E/ICEF/1990/L.6, New York, March.
Claudio Schuftan, Ho Chi Minh City.