Claudio Schuftan, Ho Chi Minh City
cschuftan@phmovement.org
Abstract
The paper proposes a conceptual framework that links the determinants of poverty and those of human rights violations. It sees both as the outcome of a cascading chain of determinants grouped as immediate, underlying and basic determinants. The framework will make carrying out situation analyses focused on poverty and human rights better adjusted to reality on the ground and is also the first step in using the human rights-based approach, a by now well established methodology being used by more and more health and development practitioners and also seen by the UN system as the way forward. The framework also provides guidance to communities in identifying, in a participatory way, the causes of the causes of the problems that affect them. Presented is the framework in a diagram format followed by a complementary list of the major determinants in each of the above causal levels.
For at least two decades, the conceptual framework developed and adopted by UNICEF in 1990 has been used by development workers in an effort to interrupt the presumed causal chain of preventable malnutrition and preventable deaths, as well as to articulate plans of action to concomitantly address the different levels of causality. In it, a distinct hierarchical causality sequence is used comprising immediate, underlying and basic causes. (1) Given its clarity and established familiarity, the same hierarchy is kept in the framework here being proposed.
However, a conceptual framework that links the causes of poverty with the causes of specific human rights violations (e.g., of the human right to health, to nutrition and/or to education), to show how they reinforce and potentiate each other, has not yet been developed. It is the purpose of this paper to propose such a framework.
Most conceptual frameworks of causality are presented as a pyramid with the structural causes at the base. The one proposed here rather reflects the “cascading down” of the causality chain and puts the basic causes (the ‘causes of the causes’ of WHO’s Report on the Social Determinants of Health) (2) at the top and the outcomes or
manifestations at the bottom. This said, the framework makes it clear that we are here talking of causes woven into a framework with distinct different levels of causality as already suggested by UNICEF in 1990 and still widely in use today.
The conceptual framework presented below as a flow chart still leaves many unanswered questions though. That is why, the author further provides a complementary list of the major causes or determinants (used as synonyms in this paper) of both poverty and of human rights violations at the beginning of the 21st century. (3)
The conceptual framework is proposed as the basis to carry out future situation analyses and as the first step towards the wider application of the human rights framework in development programming. The framework is thus designed to help identify the major causes of human rights violations in each local context and at each level of causality, as well as to help identify the key individuals and organizations who have entered (or not) into their expected roles as claim holders and as duty bearers. This, in turn, will allow its users:
• to analyze claim-duty relationships,
• to match the analysis of the respective capacities of claim holders and of duty bearers to discover key gaps, and
• to identify candidate actions to become part of a program design aimed at reverting human rights violations that in each and many ways lead to and/or perpetuate poverty –the latter acknowledged as perhaps the foremost human rights violation (or rather the outcome of many individual human rights violations). (4)
Linking poverty and human rights in a conceptual framework links the former to the human rights-based approach that is actually a, by now, well established and accepted framework for action (2). Equity –a social justice term– is intimately linked to the human rights-based approach, but the latter, more precisely, deals with issues of equality (e.g., of access, in front of the law, as relates to non-discrimination).
It is hoped that the framework hereunder will contribute to a more realistic application of the human rights-based approach to development planning, primarily because it puts the basic causes of human rights violations in a more central and pivotal place of the Assessment, Analysis and Action cycle as we plan to achieve disparity reduction –our real aim, as opposed to poverty alleviation. The real challenge is thus to ultimately lead to actions that address the human rights concerns raised in the framework –individually and as a whole, because action at each causal level is necessary, but not sufficient.
When planning for and devising solutions, framework users should advance from working on implementing coping measures, to implementing reform measures and ultimately to implement mobilization strategies that help claim holders actively place concrete demands for needed structural changes. The process should then progress from local and immediate measures to those that are more global and long-term and that address the basic causes of poverty and deal with the contributing concomitant violations of human rights.
For many years, UNICEF’s Causality of Malnutrition Conceptual Framework has been key in helping communities to identify a hierarchy of causes in their particular contexts. One of its great advantages has been that it provides guidance to communities in first identifying the manifestations of the problems they have by getting its members actively involved in participating. In a second step, they can move to identify the immediate causes, but mainly those that relate directly to the particular manifestations they have identified. Only afterwards can underlying and finally basic causes be identified. It is thus proposed that the conceptual framework be applied literally backwards, i.e., from the manifestations of the problems upwards.
CONCEPTUAL FRAMEWORK LINKING THE CAUSES OF POVERTY AND OF THE VIOLATION OF HUMAN RIGHTS.
BASIC
CAUSES
Pertaining to structural factors and to the values and practices they impose.
A. The dominant global neo-liberal economic and development imperative with its increasing concentration of wealth, its maldistribution of resources, its
existing laws, and its national and international institutions that discriminate against poor people, against minorities and against women and thus
condones the violation of their respective human rights.
B. Some aspects of prevailing traditional/religious belief systems.
C. Man-made disasters (and inadequate response to natural disasters).
UNDERLYING CAUSES
Pertaining to the underlying attributes, attitudes and characteristics of:
– the individuals who condone the violation of others’ human rights (in their role as duty bearers),
– the individuals whose human rights are violated (in their role as potential claim holders).
Inadequate enforcement of the UN human rights covenants and conventions, and of the human rights framework. E.
-Powerlessness of discriminated people to hold society accountable for its policies and practices.
-Discriminated people and groups (still) relegated to a state of resignation and inaction.
IMMEDIATE CAUSES
Pertaining:
– the day-to-day means of domination and control used by those who condone the violation of human rights,
– the organizational means to resist at the disposal of those whose human rights are violated. F.
– Overseas Development Assistance and national laws and policies not consequent with already ratified UN human rights covenants.
– Promotion and defense of an outcome-driven and process-insensitive, non-empowering global development paradigm.
– Insufficient/inadequate/no efforts made and barely any resources allocated by the inter-national community, the State and the private sector to switch to seriously applying the human rights framework.
-(Still) insufficient and inadequate community and civil society mobilization to become an effective counter-power to the prevailing unfair, unequal, top-down, non-empowering, human rights-violating economic development paradigm.
-Great deficit in human rights learning opportunities.
OUTCOME, MANIFESTATIONS
The situation to challenge through empowerment and social mobilization. H.
Political, civil, economic, social and cultural rights of vulnerable, discriminated and poor people and groups in society violated the world over resulting in illiteracy, poverty, marginalization, discrimination, and other social injustices, as well as in excess preventable deaths, preventable ill-health, malnutrition and other reduced quality of life indicators.
MAJOR DETERMINANTS OF POVERTY AND OF THE VIOLATION OF PEOPLE’S RIGHTS BY CAUSALITY LEVEL AS PER THE PRECEDING CONCEPTUAL FRAMEWORK DIAGRAM.
[Listing of the determinants hereunder is illustrative rather than comprehensive. Lettering corresponds to the respective boxes in the preceding diagram. Numbering used does not indicate order of priority or importance. There is an inevitable overlapping and clustering of the determinants here presented with some of them extending beyond one level and others interacting with each other more horizontally at the same level of causality].
BASIC CAUSES OR DETERMINANTS [Pertaining to structural factors and to the values and practices they impose].
A. The dominant global neo-liberal economic and development imperative with its increasing concentration of wealth, its maldistribution of resources, its existing laws, and its national
and international institutions that discriminate against poor people, against minorities and against women and thus condones the violation of their respective human rights: (the roots of
“power abuse” of Michel Foucault) (6, 7, 8, 9)
1. National and international inequities and inequalities brought about and perpetuated by a freewheeling market economy, by crippling foreign debt, by structural adjustment policies, and by the ongoing spread of the negative effects of globalization.
2. Unfair concentration of economic and political power (both globally and locally with unlimited growth of the wealth of the powerful and without provisions to address and sustain the well-being of all).
3. Insufficient interventions to redress the problems of the socioeconomically most vulnerable.
4. Increasing and sometimes extreme concentration of corporate wealth.
5. Unfair terms of trade (not being redressed by the WTO and less so by regional or bilateral free trade agreements).
6. No evidence of an explicit focus of development on disparity reduction and on human rights (no real political interest of leaders in this matter, despite the respective Millennium Development Goals and now numerous Poverty Reduction Strategy Papers). (10, 11)
7. Mockery of representative democracy with rigged electoral processes and election campaign financing by wealthy special interest groups.
8. Wars fought for mainly economic reasons resulting in devastating direct and indirect human rights violations.
9. Huge military expenditures that take a big toll on human and environmental well-being and that divert funding from spending on redressing violated human rights.
10. Poor people having no ownership of the means of production (especially land), and having no access-to and/or control-over the resources they need to pull themselves out of poverty.
11. Cash crops take the best land and subsistence farmers are pushed to marginal, infertile and eroded land with limited access to irrigation.
12. Export from wealthy nations of subsidized agricultural commodities to poor countries which makes it impossible for local farmers to compete.
13. Low agricultural producer prices and high cost-of and limited access-to agricultural inputs and exploitative commercialization circuits for agricultural commodities.
14. Rural and urban un/underemployment.
15. Low wages/high inflation.
16. Limited income generation opportunities (especially for women).
17. Economic development focused on aggregate and not re-distributive growth, and, therefore, without realistic and explicit disparity reduction goals.
18. Poverty reduction schemes imposed by Northern financial and foreign aid institutions (WB, IMF, bilateral aid agencies) that put the blame of poverty and the burden of reverting it on poor people without adequately addressing the structural and macro-economic causes of poverty. (PRSPs also not addressing the latter causes and –if they do– not funding pertinent interventions even to near the levels of what is needed).
19. Further concentration of wealth through international speculative financial investments, capital flight, corporate acquisitions/mergers, banking sector bailouts and other such similar operations.
20. Development and structural adjustment policies with no explicit focus on redressing human rights violations. (Beyond lip-service, no real political interest of leaders in this matter).
21. Laws and practices condoning corporate and individual political influence buying –the latter interfering with ‘democratic’ election processes and resulting in a) low voter participation, b) the election of cronies and c) the continued exploitation of the poor.
22. Corporations and special interest groups exerting pressure to oppose/undermine new/existing legislation, regulations and practices that currently concentrate wealth in the hands of a few and put the environment and human well being at risk.
23. Powerful medical establishment and pharmaceutical houses putting profits before human needs, and price life-saving services and drugs out of the reach of the neediest.
24. Failure of the US Government to adequately support the UN and the International Court of Justice, and to endorse many of the international covenants that protect human rights (e.g., the International Convention on Economic, Social and Cultural Rights, the conventions on the rights of the child and on the discrimination against women, as well as war-related international treaties).
B. Some aspects of prevailing traditional/religious belief systems: (12)
1. Fundamentalism’s growing influence in the South as a reaction to unjust, human rights-violating political systems, and in the North as a hawkish reaction to terrorism (e.g., the American religious right).
2. Practices of some healers (both traditional and modern) who misuse and mystify their healing arts and overcharge and take advantage of poor people.
3. Practices such as genital mutilation and the opposition to modern contraception methods and to sex education or to polio vaccination that violate the rights of girls, women and children.
C. Man-made disasters (and inadequate response to natural disasters): (13, 14)
1. Ethnic and religious conflict leading to violence.
2. War and civil war.
3. Other man-made disasters (e.g., toxic and oil spills, deforestation cum erosion, desertification, soil salinization in big irrigation schemes).
4. Famine and the “silent epidemic of chronic hunger” –both as man-made calamities.
5. Inadequate and late response to natural disasters.
6. No timely and effective a) disaster preparedness, and b) conflict resolution measures.
7. The impending disasters of global warming and climate change due to powerful interest that put short term gains for the few before sustainable development practices.
UNDERLYING CAUSES OR DETERMINANTS [Pertaining to the underlying attributes, attitudes and characteristics of: – the individuals who condone the violation of others’ human rights (in their role as duty bearers), and – the individuals whose human rights are violated (in their role as potential claim holders)].
D. Inadequate enforcement of the UN human rights covenants and conventions and of the human rights framework denoting a lack of (or too weak) commitment by the State and other key local, national and international development actors to abide by the same: (15, 16, 17, 18)
1. No explicit and shared conceptual framework available heretofore for claim holders and duty bearers to fall back-on bringing together the major causes of the ongoing violation of poor people’s rights by causality level in a veritable, linked causality chain.
2. Long history of sectoral approaches applied to development rather than using the more comprehensive human rights-based approach to tackle the major causes level by level as per such a conceptual framework.
3. Lack of qualified human rights-trained personnel in the public and non-governmental sector with a committed human rights orientation.
4. Inadequate, imported donor (mostly sectoral) development models with a greater focus on outcomes than on processes being implemented.
5. Male-dominated/male-focused development models.
6. Environmentally insensitive development policies.
7. Focus on strengthening coping strategies in use and on allegedly proven ‘success factors’ that address and are limited to the immediate causes, without concomitantly tackling the longer-term underlying and basic causes of poverty.
8. Poverty Reduction Strategy Papers not really owned by the governments that ‘authored’ them and that have often been prepared without a) substantial enough civil society inputs, and b) substantial enough budgets.
9. Millennium Development Goals used as isolated, individual goals –failing to relate them to the main aims of the Millennium Development Declaration (where they come from) which does place them in the proper overarching human rights context. (10)
10. No capacity analyses being carried out to identify relevant groups with claim holders and duty bearers roles.
11. No focus on setting-up positive, participatory Assessment, Analysis and Action processes that place more forceful claims on duty bearers to reverse existing violations of human rights.
12. No true decentralization of government decision-making and of government budgets; no devolution of power to the local level.
13. No attempt to counter corporate inroads in the national economy with their negative impact on human rights.
14. Move towards the privatization of basic services with no safeguards taken for the continued access and affordability of these services to poor people and no regulation of the growing private sector to avoid a host of proven past and current abuses.
15. Funding biased towards urban and curative health care –in part influenced by the growing influence of the pharmaceutical and medical supplies industry.
16. Inadequate prevention of domestic violence with no support of the victims and inadequate actions against the perpetrators.
17. Ineffective health policies and activities to tackle the excess incidence of airborne, waterborne, parasitic and other communicable and non-communicable diseases.
18. Ineffective nutrition policies to tackle insufficient and inadequate food intake and micronutrient deficiencies, as well as the proper care of mothers and children.
19. Poor and poorly maintained, as well as understaffed health and education infrastructures.
20. Underpaid and poorly motivated public servants; scant continuing education opportunities.
21. Focus on more academic, top-down, workshop/lecture-based learning that divorces theory from practice and from a more open-ended, collective, problem-solving learning process.
22. No accountability, no transparency, corruption.
23. Legal system that emphasizes punishment over rehabilitation and that disproportionately targets poor people and ethnic minorities.
E. – Powerlessness of discriminated people to hold society accountable for its policies and practices. (Denotes an individual and collective vulnerability of poor and discriminated people
and of poor countries who do not have access-to and control-over needed livelihood and development resources).
– Discriminated people and groups (still) relegated to a state of resignation and inaction: (the roots of “obedience abuse” of Michel Foucault) (19, 20)
1. People who happen to be poor with: a) no capital other than their mostly unskilled labor force, b) limited job opportunities, c) low household income, and d) virtually no access to (non-usurary) credit, especially for women and for actors in the informal sector of the economy.
2. Poor women with virtually no income of their own and no property rights.
3. Inadequate care of women and children’s needs.
4. Many unmet household members’ entitlements.
5. Little respect for minorities, women’s and children’s rights.
6. Different forms of abuse and economic exploitation (including TNCs in export processing zones).
7. Virtually no enforcement of existing laws that do protect, respect and fulfill human rights.
8. Virtually no legal protection from economic and other abuses; active anti-unionization/union busting efforts by employers.
9. Powerlessness or deliberate disempowerment of poor people that had a previous higher power status situation.
10. Scanty access to relevant information for poor people to be empowered.
11. Illiteracy (especially female), limited livelihood skills, and not enough programs to address these.
12. No universal access to education (especially girls), to health, to clean water and a to sanitary environment.
13. Household food insecurity (seasonal or year-round).
14. Excess post-harvest food losses.
15. Physical displacement of poor people (often forced).
16. Urban migration to slum areas with critical housing and sanitary conditions and residential overcrowding.
IMMEDIATE CAUSES OR DETERMINANTS [Pertaining: -The day-to-day means of domination and control used by those who condone the violation of human rights, and -the organizational means to resist at the disposal of those whose human rights are violated].
F. – Overseas Development Assistance and national laws and policies not consequent with already ratified UN human rights covenants.
– Promotion and defense of an outcome-driven and process-insensitive, non-empowering global development paradigm.
– Insufficient/inadequate/no efforts made and barely any resources allocated by the international community, the State and the private sector to switch to
seriously applying the human rights framework: (16, 21, 22, 23)
1. No priority given to setting up concerted community mobilization processes directed-at holding duty bearers accountable to find viable solutions to the causes of poverty/deprivation/underdevelopment with their ensuing violations of human rights.
2. Overt or covert opposition to spontaneous organization efforts by the population to offer counter-power to the forces responsible for their rights violations.
3. More ‘controlled’ than empowering community participation encouraged in the decision-making process dealing with development issues, i.e., the poor may be given voice, but not influence.
4. Poor people not allowed to become real protagonists in their own development; they are rather relegated to become passive receivers of development handouts.
5. Poor people given very limited access to the information they need to make their concrete demands more effective. (“Institutionalized disinformation is the modern means of social control”).
6. No concerted actions by development projects to give communities progressive and effective control over critical resources and decisions.
7. Little effort to train human rights community mobilizers (leaders).
8. No national human rights commission with sufficient power to monitor the enforcement of political, civil, economic, social and cultural rights.
9. As needed for a human rights-based approach to development, duty bearers (those who should be responsible for making sure human rights are realized) not being identified and targeted and no concrete demands being placed in front of them.
10. Eroding community support mechanisms not receiving sufficient attention and action (especially in communities stricken by AIDS).
11. Workers not allowed to organize and/or to get involved in development questions; labor unions often not allowed, beheaded of their leadership, or co-opted.
12. The educational system focused on training students to obey and compete, rather than to think, analyze and work together for equitable changes and to oppose the violation of human rights.
13. Conspicuous absence of the private sector (or participation with a dubious self-interest motivation) in the participative development debate and praxis in an effort to have enterprises commit to and enforce human rights principles.
G. – (Still) insufficient and inadequate community and civil society mobilization to become an effective counter-power to the prevailing unfair, unequal, top-down, non-empowering, human
rights- violating economic development paradigm.
– Great deficit in human rights learning opportunities: (24, 25)
1. Poor, marginalized and discriminated claim holders with no ability/recourse/power to compel relevant duty bearers to fulfill their human rights obligations.
2. Capacity building/skills acquisition sponsored by projects not focusing sufficiently on effective community mobilization skills needed to counter local sentiments of fatalism and/or passive disenchantment.
3. Dearth of human rights trained community mobilizers (leaders)
4. Poor people may see their needs not fulfilled, but do not know the same correspond to their actual internationally sanctioned rights; this, in the areas of:
• Overall health and reproductive health, of nutrition, of water and sanitation, and in the care needed by women and children.
• Education and literacy, of technical (vocational) training and in livelihood skills.
• Employment, of credit, of agricultural and other subsidies, as well as in income, and in housing.
• Physical protection (especially women and children), of social services and in healthy leisure options.
• How to effectively organize to mobilize communities so as to gain voice, influence and political bottom-up power.
5. Poor people do not see the link of the following to their inalienable rights:
• The vicious circle of malnutrition and infection that leads to a downward spiral ending in premature deaths.
• The environmental contamination and the unsustainable exploitation of renewable resources in the commons (e.g., timber, fuel wood and charcoal, fish) that result in critical, non-reversible surrounding environmental degradation.
• The failure of government to sustain and adequately fund the provision of all basic services, including health, nutrition, water and sanitation, basic housing, education and day-care services.
• The poor management of existing basic services which are of low quality (e.g., insufficient and irregular supply of essential drugs and other medical supplies in public health facilities) and are thus underutilized by poor people.
OUTCOME, MANIFESTATIONS [The situation to challenge through empowerment and social mobilization].
H. Political, civil, economic, social and cultural rights of vulnerable, discriminated and poor people and groups in society violated the world over resulting in
illiteracy, poverty, marginalization, discrimination, and other social injustices, as well as in excess preventable deaths, preventable ill-health, malnutrition and
other reduced quality of life indicators: (26, 27, 28, 29)
1. Inappropriate and misdirected development projects that are not decreasing the historical inequities, social injustices and human rights violations of the prevailing development model.
2. The current inequitable macroeconomic system with its institutionalized violations of human rights hardly being challenged.
3. Few effective disparity reduction plans/programs in place –plans in which people who happen to be poor have a say.
4. Many poor and near-poor people with no physical and economic access to basic services (overall health, reproductive health, agricultural extension, education, literacy and livelihood skills training, among the most important).
5. High rates of preventable ill-health, preventable malnutrition and preventable mortality.
6. No family security (with a host of family members’ rights being violated).
7. Environmental degradation; man-made actions hastening climate change.
8. Minorities and gender discrimination; women’s and minorities’ rights denied.
9. Urban criminality, drug abuse problems, religious radicalization of frustrated youth, increase in commercial sex work and in the spread of AIDS.
Epilogue:
Although hierarchically grouped, the above is indeed a long list of causes or determinants in need of being addressed. As the reader has noticed, the long list
further points towards potential corrective actions we need to embark on. This is certainly not meant to make the reader throw up her/his arms in frustration at the huge number of things that have to be done. Strategically, to deal with the 104 determinants listed in the myriad contexts where it is hoped this framework will be a viable contribution, the key principle underlying what is presented in this paper is one of a participatory bottom-centered approach, i.e., creating the opportunities to discuss the framework and the long list with claim holders and duty bearers in each location. Such an exercise has an intrinsic politically empowering value and certainly allows for other location-specific determinants to be added. It is these discussions that will come up with the priority mix of realistically actionable interventions appropriate for each context. What is non-negotiable is for users of the framework to understand that acting on the listed determinants at the immediate and underlying causal levels only is not sufficient: The mix of actions selected has to address causes at all three levels simultaneously –the emphases in each situation being case specific.
Acknowledgements: I would like to thank George Kent, Alison Katz and Urban Jonsson for comments received.
[References available upon request].