We all know that it is easier to fight for one’s principles than to live up to them.
- Human rights activists are repeatedly faced with the need to figure out the four or five most binding constraints that are behind major human rights (HR) violations to then focus on lifting those few as a matter of priority. This is not an easy task in the area of health. The obvious risks in this are (a) trying to fix all the problems at once, and (b) starting with reforms that are not crucial. It is, of course, best to focus on the reforms whose direct effects are expected to be significant. As a rule of thumb, across-the-board reforms are politically difficult and often fail.
- A decision tree methodology, used in conjunction with the claim holders, helps to identify the most binding constraints. The aim is to differentiate the essential (and important) from the merely desirable (and just interesting).
- But to concentrate on just four or five constraints, our peer activists must have knowledge of most other prevailing constraints, as well as the capacity to remove them. And this is not easy in the area of health. Most constraints must thus be identified in both the corresponding situation and capacity analyses. Therefore, a key step in the situation analysis is to figure out which of these constraints more directly and acutely refers to the identified major HR violations.
- To subsequently make the right choices, the activist needs do develop a strong sense of the consequences of potential policy changes. To do this, empirical hypotheses will often have to be tested using indirect evidence across time and geography. Based on the strength of such empirical evidence, claiming for the needed institutional (and health sector) reforms becomes more reasoned. (It is noted that it is much more difficult to find empirical evidence of what tomorrow’s constraints will be. Future expected bottlenecks have to be identified soonest though and acted upon as early as possible).
- To perhaps complicate things a bit, HR activists have to adapt to changing circumstances without losing sight of the ultimate aim which is the removal of the most pressing HR violations. That is what makes for success stories.
- This having been said, keep in mind that:
- a) When serving higher human rights designs, it is not good to make more than the absolutely necessary concessions on the lesser evils.
- b) HR activists:
-do get actively involved (they bring the HR issues to a level of what sub-comandante Marcos called ‘impertinent consciousness’ where it bothers them not to get involved);
–do have painful doubts when doing so (only imbeciles have no doubts*);
-are biased in their approaches [in many countries in the world, being impartial does not mean anything more than belonging to or sympathizing with the party in power (Guillermo Cabrera Infante)]; and
-do take insults in their everyday work (insults are forgotten; it is hatred that brews slowly…).
- Finally, HR activists should follow Dag Hammarskjold’s maxim that says: To improve oneself, we need to be: simpler, quicker, warmer and firmer.
Claudio Schuftan, Ho Chi Minh City