Claudio Schuftan, Ho Chi Minh City
Effective action requires not just a feeling or enthusiasm, but calls for a close rapport with the disgruntled so as to get them organized.
You may often have asked yourself as to whether your individual contribution to development in the field of health and nutrition makes or is making any difference.
This, of course, depends. Alone, each of us is indeed helpless to change very much. Standing alone is a false ideal. We[1] have thus plenty to learn from the lessons of mutuality or even of militancy. Individual compassion is just less powerful than organized solidarity. Or, to use an old adage, ‘divided one begs, united one bargains’.
Grassroots-organized sporadic, collective acts are happening all the time–mostly the result of non-political and personal leadership initiatives. To make these really count and add up to something, they need to be progressively channeled into new patterns of higher political meaning and impact. Activists are needed to lead the way in such a transition. This, because without continuity and follow-through action, popular struggles will remain a heap of toothless words.
In our context, two questions arise: Are the fields of health and nutrition legitimate and good ports of entry for such activism, and if the answer is yes, are we ready for such a challenge?
Again, if the answer is yes, new forms of progressive action and education are needed in our line of development work and, to act effectively in the time before us, we need to first develop a widely shared strategy pointing in this direction. In such a strategy, we cannot merely denounce; we must also announce a new order, an order with more empowering health and nutrition alternative actions. We must strive to become proactive, not merely reactive. Today, the inescapable challenge is, together with claim holders, to redefine the strategies to be used in order to combat ill-health, malnutrition and maldevelopment all the way from its global determinants. Only thus will we be able to solve the present crisis in overall development thinking and praxis we find at so many local levels.
As an avant-garde, we need to reflect not only on new institutional ways of supporting grassroots initiatives, but we need to become proactive in organizing them and then helping generate new forms of knowledge and new practices of democracy and local government. In the process, we also need to help redefine the significance and the role of foreign aid and other forms of international development cooperation in the fields of health and nutrition to better adapt them to the felt needs of local communities. If the latter cannot be done, it is high time we begin considering turning foreign aid down.
Still proactively, we first need to help create a shared critical awareness of the immorality of the prevailing economic and social system responsible for the preventable ill-health and malnutrition we are increasingly left to deal with. We need to motivate people, both in the North and in the South, to change the mechanisms that lead to these conditions of poverty and injustice, and this can only be achieved by creating growing dismay and vocal (constructive) anger at such injustice.
Action along these lines (preferably preemptive) should even be considered to be an inescapable outcome of effective health, nutrition and development education. The activist/educator thus has a role in our midst.
If we are to be consequent with effective popular participation and if we are to foster an authentic people-centered development (in our case using health and nutrition as a port of entry) we will have to:
- move away from coercive, top-down practices involving any kind of forced acceptance and move into consensus-building practices involving legitimate claim holders’ approval and involvement;
- do things departing from the way people see them in their own environment;
- revolutionize people’s expectations, helping them to move away from fatalistic outlooks;
- help define a new type of collective to replace the existing situation that consists of individual identity and community responsibility;
- help legitimize and enforce all UN-sanctioned people’s rights;
- increase the negotiation and bargaining capacity–or at least the defense capacity– of claim holders;
- aim at modifying constraining local, formal and informal political structures as needed;
- concentrate on changing the local generational dynamics when required, especially on changing the role of women (our main contact in health and nutrition work) in overall development as well as combatting patriarchy;
- work with people towards the goal of ultimately controlling their own resources, fighting for resources they need from outside, and taking initiatives to shape their own future through strengthened, militant organizations;
- make sure claim holders get access to relevant information, especially the type of information that will help them hold their (duty bearer) government officials accountable; (information given to people for use through the fashionable social marketing approach is definitely not the type of information conducive to any meaningful participation or social change; social marketing simply does not bring about the needed sustainable structural changes–at best, it allows people to cope with an unjust situation).
- help redefine the roles and methods of ‘participation,’ in our case in health and nutrition;
- constantly re-gather groups being marginalized trying to make sure their special interests can be accommodated in the general strategy;
- secure concrete short and long-term results for claim holders (with an initial emphasis on the former to foster self-confidence);
- monitor and evaluate said results, especially with regards to the degree of popular participation being achieved, as well as probing the equity of the benefits accrued;
- promote self-education with the aim of achieving rapid results.
Only the constant practice of such people-centered development activities through trial- and-error will overcome the limits of existing flawed development models and theories.
In short, starting with/from health and nutrition and through trial-and-error, we should all contribute, to the best of our abilities, to generate popular alternative development strategies and the corresponding set of tactics to implement them. But to make a difference, remember that standing alone changes little; so network with other like-minded activists in this field!
[1] In aspirational writing, progressives often address their writing to “we.” This refers to the writing, the readers, and other like-minded progressives.