A campaign for health care

Print edition : December 23, 2001
SUHRID SHANKAR CHATTOPADHYAY in Calcutta

CALCUTTA played host to the first National Health Assembly, held on November 30 and December 1. Over 1,950 people, including doctors, government officials, politicians, delegates from non-governmental organisations and peoples' movements, village health workers, researchers and educationists, from 18 national networks took part in the seminars organised at the Salt Lake Stadium to address the crisis facing the health care system. The seminars pointed to the fact that the promise of 'Health for All by 20 00' made at the World Health Assembly at Alma Ata in 1978 remains unfulfilled. Basic issues of physical, mental and social health were discussed.

The speakers included National Alliance of Peoples' Movements leader Medha Patkar, economist Amiya Bagchi, former Director-General of the World Health Organisation (WHO) Hafdan Mahler, convener of the NHA and Vice-Chancellor of Kerala University Dr. B. Ekbal, NHA Chairperson Dr. N.H. Antia and West Bengal Health Minister Partho De. The fact that the benefits of the remarkable discoveries made in the field of health and medicine have not reached all levels of society, and the abysmally low level of awar eness among the people, especially in India, of basic facts about health care were highlighted. With drug prices having increased by leaps and bounds, essential medicines are becoming increasingly unaffordable. The child malnutrition level in India stand s at 53 per cent, and the infant mortality rate is 70 deaths per thousand births.

Owing to several factors, globalisation being one of them, government expenditure on health and education has been slashed. According to Dr. Ekbal, only 21 per cent of the total government expenditure in India is allocated to health care. Even Bangladesh has a more impressive figure. There are serious threats from new diseases such as Acquired Immune Deficiency Syndrome, while even old ones like dengue, kala azar, malaria, plague and tuberculosis are yet to be eradicated.

Exhorting people to join together and demand their right to good health, Medha Patkar said: "We have been hearing excuses for 53 years. Now we shall not wait any more... We want health, not diseases."

Amiya Bagchi felt that the decline in health awareness and the pathetic living conditions of the poor, who often cannot afford the required medicines, are largely because of globalisation. "Globalisation has been created by the rich to serve their own pu rpose... In today's world of globalisation, the mortality rate of the poor is 75 per cent more than that of the rich," Bagchi said. He said it was this inequality that prevented the development of a healthy world. Hafdan Mahler, the architect of the Alma Ata declaration, told Frontline: "This (the Health Assembly) is a very positive thing that has taken place. It is a conscientious effort by the people to do something about an issue of utmost importance. It is only through movements like this tha t a change for the better can come about."

On December 1, the 'People's Health Charter' was read out by Laxmi Sehgal, who was a captain in the Indian National Army. The participants took an oath to carry out a political campaign to ensure health for all. "We declare health as a justiciable right and demand the provision of basic health care as a fundamental constitutional right of every one of us," the Charter states.

Among other things, it demands a decentralised system of local self-governance with adequate finances provided to the local bodies, a drug industry geared to produce epidemiologically essential drugs at affordable prices and a health care system that is responsive to the people's needs and whose control is vested in the people's hands. The Charter demands that the concept of comprehensive primary health care should "form the fundamental basis for formulation of all policies related to health care."

An impressive procession with a 30-foot banner was taken out from the Calcutta University campus. Thousands of people joined the march with their own banners and flags.

"The National Health Assembly was the culmination of a public awareness campaign begun on April 7, World Health Day. We started involving people throughout the country through workshops, poster campaigns, seminars, surveys and conventions," Dr. Ravi Nara yan, one of the architects of the campaign and a member of the National Coordinating Committee, told Frontline. Touring street theatres were used to spread the message of health in the districts of Kerala, Tamil Nadu, Andhra Pradesh, Karnataka, We st Bengal and Tripura. The campaigns in the various States were conducted by the State Coordination Committees (SCC). In Kerala, a series of lectures were held in all the 1,000 panchayats and in Tamil Nadu the campaign covered over 160 blocks in 23 distr icts. Twenty-two districts were covered in Uttar Pradesh, 140 blocks in 35 districts in Bihar, 500 villages in 18 districts in Andhra Pradesh, 50 blocks in 15 districts in Karnakata, five districts in Assam and 15 districts in Orissa. In Gujarat and Trip ura all the districts were covered. In West Bengal, the SCC has 75 organisations, the highest among all the States. According to Dr. Narayan, the whole team assisted in organising the NHA. In Delhi, besides six health melas, an intensive signature campai gn was organised. Campaigns were also organised in Maharashtra, Madhya Pradesh, Chattisgarh, Haryana, Rajasthan and Himachal Pradesh. The feedback from all the States was presented to the National Coordination Committee.

Dr. Ekbal told Frontline: "Ultimately, the fact that the NHA was such a success is all that matters. It was no easy task to bring so many groups with their different ideologies together. However, the response we got from them was tremendous.

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