Human Rights Reader 238

 - If the people will lead, the leaders will follow. (M.  Gandhi)

- Changes in human rights are hardly ever achieved in a simple straightforward way –they bring about interior power struggles and resistance which need to be dealt with people’s counter-power. (F. Holtmeier) It is thus people’s counter-power that has to create demand for change.   

- In human rights work, participation is not about pointing our fingers, but about raising our hands to be counted. (S. Koenig)

I have gathered many statements about participation and empowerment (by far not all my own) that I think qualify for the status of ‘iron laws’ in our human rights (HR) work. Here they are:

1. Participation is not just a consultation process; we understand it as an empowerment process. (Reminiscent of the principle of magnetic resonance, empowering participation seeks ‘social resonance’).

2. People need outlets to voice their complaints about the injustices and HR violations they are subjected to.*

*: For instance, community-based health committees attached to health facilities should be able to hold doctors and health staff accountable and, if necessary, request they be replaced.  (P. de Vos)

3. In HR work, we must guarantee that the voice of those whose HR are being violated is heeded. But it is not only having voice: It is getting to the position of having influence.

4. The challenge of actually ‘taking part’, is thus ultimately the challenge ‘to be counted’. Ergo, making decisions is what makes people’s participation effective; only then can their informed participation be used to counter- power.

5. Civil society definitely has the capacity of making the arrangements for participation to become empowering. The power gained is to make a measurable difference in public service provision as service providers are to be made accountable at multiple local levels. (G. Kendra)

6. Since laws and policies are mostly instruments for the arbitrary discharge of office holders’ power to make solo decisions (rather than a means to help hold these officials accountable), the prevalent local notions of the HR-fairness-of-laws-and-policies can only be changed by engaging the active participation of local communities. It is them who have to proactively demand laws, policies and regulations be changed, be scrapped or be put in place to make sure they are fair in a HR sense. (In this process, using the pertinent UN Covenants and General Comments should be the basis).**

**: In defusing HR violations , new/amended laws will, most probably, be necessary to define new duties and obligations of institutions and of actors. As HR workers, the problem we face is the current lack of a moral-political framework for solving social justice- and HR-related problems. (H.P. Ruger); the introduction and widespread dissemination of such a framework will have to antecede actual legal work –hence the importance of HR learning.

7. The difference between participation and empowering participation is the latter’s explicit orientation towards social and political change.***

***: We note that, for instance, the World Bank-hijacked concept of empowerment does not consider increasing the capacity of individuals to make their own choices in relation to the actions and outcomes they long for.

8. The HR-based approach (HRBA) actually evolved from the concept of empowerment. It adds to the concept of empowerment the attributes of being entitled to the universal-right-to-seek-accountability through varied mechanisms and of having equal-rights-to-claim, to-demand-and-to-seek-redress. (P. de Vos) 

9. The type of empowering participation the HR framework fosters starts with claim holders understanding how final decisions are made (who? when? using what criteria?)

10. In empowering participation, calls for fairness that do not, early on, name who-is (i.e., the pertinent duty bearers) and what-the-forces-are behind the perpetuation of inequities and HR violations, are not really empowering. (A-E. Birn)

11. Achieving an empowering participation in the HR sense is ultimately going to be a block-by-block, household-by-household seven-days-a-week job.

12. Empowering participation processes are not cost-free; they need sustained funding. Moreover, keep in mind that empowerment processes are not linear; they evolve in quantum leaps.

13. When fostering empowering participation in HR work, we will face both contingent and organizational barriers that will attempt to prevent us from introducing the HR framework as the basis of our work.****

****: In the health professions, the biomedical training students get fosters hierarchical attitudes that act as further barriers to participatory approaches. (L. Morgan)

14. To tackle the organizational barriers, we have to start by identifying what impacts and worries people so as to link and translate those worries to concrete violations as related to the precise wording of UN HR covenants’ clauses.

15. Also early-on in empowering participation, it is necessary to talk about the ‘HR debt’ of governments and about the need for a change of paradigm that introducing the HR framework is all about. (M. Ovalle) 

16. Thereafter, still using the HR framework, the sequence of activities to follow will be: to inform, to educate, to empower, to set an agenda and to mobilize.

17. Genuine people’s empowering participation is that in which the most disadvantaged social classes and groups –those underrepresented in society– are duly represented in leadership; only this ensures the active engagement of marginalized and discriminated groups in gathering and achieving the needed  counter-power. (Caveat: This representation does not automatically decrease the risks of paternalism, patriarchy and bureaucratic overpowering).

18. As regards adapting women’s participation to make it empowering, you will have to read between the lines…since there rarely are more than a couple lines in conventional development plans when it comes to women’s issues. (I. Allende)

19. Participatory-Budget-Analysis, Participatory-Village-level-Social-Auditing and Citizens-Report-Cards are relatively new working tools with immense potential in HR work.

20. Monitoring is also an activity to be made participative; it entails embarking, jointly with beneficiaries, on monitoring the overall direction in which development interventions are being steered, their performance, the processes being applied and, last but not least, the outcomes.

21. Bottom line, empowering participation fosters enough collective strength to influence power relations. Ultimately, the process seeks to challenge the powers-that-be responsible for the status-quo of which HR violations are  part and parcel.

22. Genuine people’s participatory processes also beg for solidarity. Solidarity work is a) to be seen as a further political and HR task that supports the development of a strong democratic citizenry, and b) to be used to support, replicate and multiply citizens organizations and to mobilize them around HR principles so that a wide HR movement can be consolidated.

23. HR work thus capitalizes on the ethical sense of solidarity as it promotes a new image of a fair and just society by opening the doors to a new reflection about the transformative power of the application of the HR framework.  And finally,

24. Since there are a host of new possibilities for political participation and solidarity, internet communications have become an important political factor in HR work –a factor to reckon with and to take advantage-of.

Claudio Schuftan, Ho Chi Minh City

cschuftan@phmovement.org   

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Partly taken and adapted from D+C 36:2, Feb 2009; D+C, 36:5, May 2009; H. Potts, Participation and the Right to the highest attainable standard of health, HR Centre, University of Essex, 2008; Campania 2007 por el derecho a la salud en Uruguay, diciembre 2008; and L. Weinstein, Ed. Multiversidad, Editorial Universidad Bolivariana, Coleccion Nuevos Paradigmas, Santiago, Chile, Mayo 2009.

1. You may often have asked yourself as to whether your individual contribution in the field of health and/or nutrition makes or is making any difference.  This, of course, depends.  Alone, each of us is indeed helpless to change very much.  Standing alone to-right-the-world’s-wrongs is a false ideal. We have thus plenty to learn from the lessons of mutuality or even of militancy.  Individual concern (let alone compassion…) is just clearly less powerful than organized solidarity. (Tikkun)   Or, to use an old adage, ‘divided we beg, united we demand’.

2. Sporadic, collective grassroots-organized acts are happening all the time   –mostly the result of non-political and personal leadership initiatives. To make these acts really count and add-up to something, they need to be progressively channeled into new patterns of higher political meaning and political impact. Human rights activists are needed to lead the way in such a transition.  This, because without continuity and follow-through actions, popular struggles will remain a heap of toothless words. (S. Ophir)

3. In the human rights (HR) context, two questions arise here: Are the fields of health and nutrition legitimate and good ports of entry for HR activism? And if the answer is yes: Are we ready for such a challenge?

4. If the answer is again yes, new forms of progressive HR learning and HR action are then needed in our line of work. Actually, to act effectively in the time before us, we need to first develop a more widely shared strategy that unequivocably points in the HR framework direction.  When adopting 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 thus strive to become proactive, not merely reactive.

5. Today, together with the victims of health and nutrition rights violations, the inescapable challenge before us is to redefine the strategies we use in order to combat preventable ill-health, preventable malnutrition and preventable premature deaths. This invariably entails (simultaneously at the global, national and local levels) addressing and combating the social, economic and political determinants of the violations of the UN-sanctioned Right to Health and Right to Nutrition.  Only thus will we be able to overcome the present crisis in overall development thinking and praxis we now are stuck-in in these two domains.  (R. Boyte)

6. As an avant-garde, we not only need to reflect on new institutional ways of supporting grassroots HR initiatives, but we also need to become more proactive in organizing them, as well as helping generate new forms of HR knowledge and of practices-of-direct-democracy in local government. In the process, we also need to reassess the pertinence and the role of foreign aid and of private (non-official) international development cooperation in the fields of health and nutrition. This, to either reject both or to help redefine them so that they, once and for all, fit the demands of local communities.  (S. Padron)  If the latter cannot be done, yes indeed, it is high time poor countries begin considering turning down foreign aid.

7. Still proactively, we first need to help create a shared critical awareness of the immorality of the prevailing social, economic and political system responsible for the violations of the Right to Health and the Right to Nutrition we are basically left to deal with as health and nutrition professionals. For this, among other, we need to bring people both in the rich and the poor countries to a point where they become more vocal in their demands to change the mechanisms that lead to the conditions perpetuating ill-health, malnutrition, poverty and injustice. And this can only be achieved by creating a growing discontent that leads to a ‘constructive anger’ and to commensurate actions that address such injustice. Action along these lines is desirable (preferably preemptive rather than reactive), and should even be made an inescapable outcome of effective health, nutrition and development learning. The HR activist/educator thus has a key role in our midst.

8. If we are to be consequent with effective people’s empowerment, we will have to foster an authentic people-centered development (in our case using health and nutrition as a port of entry to HR issues). For this we will have to further:

i) move away from coercive or top-down practices involving any kind of ‘acceptance-as-a-fait-accompli’ (e.g., in family planning?), and move into consensus-building practices involving legitimate beneficiaries’ approval; ergo, do things departing from the-way-people-see-them in their own environment;

ii) revolutionize people’s expectations helping them to move away from fatalistic outlooks;

iii) help define a new type of collective, community sense of responsibility that replaces the prevailing individual identity;

iv) help legitimize and enforce all UN-sanctioned people’s rights;

v) increase the negotiation and bargaining capacity –or at least the defense capacity– of claim holders;

vi) as needed, aim at overcoming constraining local political structures (formal and informal);

vii) concentrate on changing the local inter-generational dynamics when required, and very specially concentrate on changing the role of women (our main contact in health and nutrition work) in overall development work;

viii) work with people towards the goal of ultimately controlling their own community resources, fighting for the resources they need from outside, and taking initiatives to shape their own future through a strengthened, militant organization;

ix) make sure people get access to relevant information, especially the type of information that will help them hold their government officials accountable; *

x) help redefine the roles and methods of so-called ‘participation’ shifting them towards methods of ‘empowerment’ –in our case in health and nutrition;

xi) constantly re-gather groups becoming marginalized, trying to make sure their special interests are accommodated in the general strategy;

xii) secure concrete short and long-term positive results for claim holders (with an initial emphasis on short-term results to foster self-confidence);

xiii) together with claim holders, monitor and evaluate said results, especially with regards to the degree of  popular empowerment being achieved, as well as probing the equality of the benefits accrued; and

xiv) promote self-education with the aim of achieving faster results.

*: Information given to people for use through the fashionable ‘social marketing’ approach is definitely not the type of information conducive to any meaningful participation; social marketing simply does not bring about the needed sustainable structural changes –at best, it allows people to tolerate and cope-with an unjust situation. Social marketing tells people what to do, but not what for  and why…

9. Only through the constant practice of such people-centered development activities –often through trial-and-error– will we overcome the limits of existing flawed development models and theories. (L. Padron)

10. In short, starting with/from our work in health and nutrition, we should all contribute, to the best of our abilities, to generate popular alternative development strategies with 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 the HR field!

Claudio Schuftan, Ho Chi Minh City

cschuftan@phmovement.org