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Health for All:
A Global Montage
Venkatesh M. Raghavendra, Concept & Presentation
Melodie Foster, Research & Technical Inputs
Health "is a state of complete physical, mental, and social well being, and not merely the absence of disease or infirmity," notes a declaration issued in 1978 at the international Conference on Primary Health Care held in Alma Ata, USSR (Kazakhstan). The conference was sponsored by WHO and UNICEF and attended by ministers of health from more than 100 countries.
This profound statement—worth reflecting upon even today especially as we think about health for all—proclaims that health is "a fundamental human right, and that the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector."
This montage on the topic of "Health for All" was created by conversing with people from around the world and sparked by a discussion in the Health Issues class of Professor Janaki Natarajan at the School for International Training. Recurring themes emerge here, including the importance of providing access to health by addressing systems that exclude the poor, and designing services that are equitable.
Nearly everyone agreed that the reality on the ground is far removed from their ideal vision. Global health is not just the responsibility of governments, health care providers, and the health industry. It belongs to all who believe that "Health for All" should be built on a foundation of social justice.
All people should receive health treatment—the same services regardless of their cultural status or class. Health for all could mean we should all work together to raise awareness: in schools, media, local organizations—literally everywhere.
Yaser Al Qaisi
Palestine
To me "health for all" is a two-fold concept: first, it is the ability for communities to control the conditions that impact their health and that of future generations (examples: safe drinking water or food that is high in nutrients yet free of dangerous chemicals). Second, it is about access. Communities must have access to health care or treatments when needed and wanted. This includes traditional medicines or foods as well as the ability to afford and obtain quality care at hospitals.
Jaime Arsenault
United States
We have many kinds of health—economic health, physical health, socio-political health, and so on. All these are linked. Economically speaking we have a lot of resources in my country, but people don't know how to use them and some become embezzlers. We lack hospitals in my country—they are nice outside and inside there is filth. We have great concern about malaria and AIDS.
Franz Batoh
Cameroon
The constitution of my country says Bolivians have the right to health insurance, but it's only on paper. Health issues affect rural and urban populations differently. People who live in the very rural areas are very afraid of scientific medicine—for example when women give birth they don't go to the hospital, they have a midwife. In urban areas of course we have hospitals and clinics, and private hospitals and they are very expensive. Diet and nutrition are important parts of health too.
Isabel Berrios
Bolivia
It is utterly an obligation for government to provide health for everybody. It's a must. They are responsible for everything that happens to people. In Morocco, food patterns have changed. Many people now live in peripheral areas of cities, and these are the people who are suffering from diseases—iron deficiency, diabetes, and arthritis. Why is that? A solution would be to bridge the gap between traditional and Western knowledge at school—show children that their parents' herbal knowledge is as good as or better than aspirin.
Mokhtar Bouba
Morocco
"Health for All" is a way to?create social justice by improving the lives of people through the best use of technology, knowledge, and?resources.? This?implies a social view of health as a public affair in which the major responsibility?lies in the state as supplier, educator,?and?regulator.??A combination of these three elements is more than necessary for the articulation of the health services as inclusive and efficient, and maybe it is the best way to secure health as a human right (reality) for all the people.
Francisco Burgos
Dominican Republic
Health solutions must be shared. They involve attitudes, skills, and knowledge in protection of water sources; teaching life skills and valuing the 4R principle in democracy at work: recycle, reuse, reduce, and repair. Caring for elders and the Earth with the next four and five generations in mind is central to health and well being.
Protasia Gathendoh
Kenya
Health services are not a privilege but a necessity. Absolutely nobody should be excluded, not even those who cannot afford it. Our governments should always have funds to make sure the poor can receive the necessary medicines and treatment they need. The poor and underprivileged have contributed to our societies. Poverty and ill-health may result from those contributions: the work that exposes them to risky situations and takes them away from child care. Not only do the parents suffer but the next generation is affected too.
Daydon Harvey
Bahamas and United States
In my country "health for all" means active resistance to the attempts of decentralization and privatization of the health care system, especially towards an adoption of mandatory medical insurance based on the inability of the majority to pay for this right to life. It means consideration of health as a natural right rather than a commodity to be bought and sold, and it means a return to socialized medicine, particularly the Soviet Semashko-system that guaranteed free medical care for the entire population on the basis of citizenship rather than insurance.
Olga Jouikova
Russia
In Pakistan, 68 percent of the population is in rural areas which are lacking infrastructure, education, and employment opportunities. This ultimately affects their access to health facilities. Specifically, women are the most affected population. Tribal cultures play an important role in the marginalization of women and the deprivation of health and food as the mobility of women is restricted. Lack of access to information and poverty affect the health conditions of the poor. Addressing these issues is "health for all" in my view.
Asma Kiran
Pakistan
It means that economic class does not determine my access to health care. It means affordable, high quality delivery and quality drugs for illnesses affecting the country. As an example, Colombia has a high incidence of diabetes and the monthly cost for survival is $250, more than half the minimum salary.
Claudia Leiva
Colombia
Health services should not be just a privilege, or only for the privileged. It should not depend on how much you pay an insurance company in order to receive access to something which is one of the basic needs in life. ?Health for all means, to me, the right to health service for the young and old, weak and strong, rich and poor.
Jessica Loh
Canada
As an Ethiopian, health for all means access to adequate nutritious food, clean water, shelter, and health care. The assumption might be that the leading cause of disease and death in Ethiopia is poverty and famine while actually natural disasters such as drought contribute to the health instability for segments of the population. We need to consider the class relations of the world economic system—this is the main cause of inequalities between and within countries. The question one needs to ask is who has access to adequate food and health care in a given country.
Yirgalem Madie
Ethiopia
"Health for all" implies that everyone has a right to health, and whichever model they choose, they should be provided for. The legacy of apartheid still lingers. People in rural areas do not have facilities and have to walk a long distance to clinics. My government, the new government, has vehicles that provide mobile health so that people will get health soon. And there is the scourge of AIDS which has limits as far as medicines are concerned. You have to meet certain standards to get anti-retroviral drugs, and in the meantime, people are dying.
Donna Makoboka
South Africa
"Health for all" means access to health facilities, free of charge, for at least basic treatment. It means affordable medication, availability of doctors of different specialties, and adequate and properly equipped medical facilities.
Suely Neves
Cape Verde
Health in Peru means to me health as a human right. When I think of health as a human right, I think of marginalized people who suffer several illnesses as a consequence of their life conditions. Therefore, marginalized people should have the right to access health services, as well as to organize all efforts to fight against poverty in Peru.
Rosamaria Olortegui
Peru
"Health for all" means basic health related services: that is food, nutrition and care. What is critical is proper distribution of food, medicine, and basic health care which might include insurance coverage. It is equally important to promote traditional medicine by enhancing the skills of the doctors and preserving the natural resources needed for public health.
Juhi Roy
India
In my country most people rely on traditional medicines. Generally there has been no decent access to doctors or medicine, so people have not developed confidence in Western medicine. Beyond that, health for us is not only from a medical point of view. We need access to clean water and nutritious food, as well as a healthy environment.
Phyu Phyu Sann
Burma
Health for all is something I have grown up with, but also appreciated from the moment I was old enough to grasp that this was not the standard elsewhere. Universal healthcare cannot be taken for granted. In Denmark increased privatization is undermining the foundations for equal access to quality healthcare for all. Fundamentally I believe that the right to free healthcare for all—including those most marginalized—is the only way forward. This right must not remain abstract but must be implemented in action and critical thinking every step of the way.
Anne Stoltenberg
Denmark
In my culture and context "health for all" has meant service is based on class—those with more money have better access to these services (private health services in a lot of cases)—and has only catered to those in the formal economy. To me, "health for all" means equal access to health services in the country.
Ricardo Vargas
Mexico
In China "health for all" would mean clean air, easy access to places for exercise for all people, and safe food. We have all kinds of pollution, and there is no strict monitoring on the use of chemicals for crops. Another important thing, I think, is the concept?of?how to be healthy—many people still think that it is only about eating good food. There needs to be mass education on the concept of health.
Peihui Wang
China
In Liberia, one major health issue is access to psychological health care. This situation is extremely important given the cultural implications of mental illnesses and the high level of trauma emanating from the 15 year civil war, especially as it relates to former child soldiers and generally, the war-affected population. This observation does not suggest that it should take priority over other health issues like HIV/AIDS, but it should take the limelight since mental illnesses have in recent Liberian history been pushed under the carpet. People do not admit to mental health problems and trauma in my culture. Additionally, it is difficult to get professional services as there isn't any infrastructure and expert services. My vision is that health would become holistic so that mental health would be included in national development programs. The recent elections offer an opportunity to do this.
Korto Williams
Liberia
Health should be accessible, affordable, and local-based. Accessible means that poor people, the majority of people, should have access to services provided by the government or any other agency. Affordable means these people, based on income, can still afford these services. Local-based means local capacities, traditional medicine, knowledge, and resources are used.
Agung Wiyono
Indonesia
Authors:
Venkatesh Raghavendra is Ashoka's Director, Global Partnerships for Asia, and has been with Ashoka since 1999. He has worked closely with social entrepreneurs including those active in the health arena. He spent 13 years working in the rainforests of South Western India, also known as the Western Ghats and one of the top bio-diversity hotspots of the world. During this period he lived and worked with the indigenous peoples of this area on various issues including the access to health for these communities.
Melodie Foster is a candidate for a master's degree in Intercultural Service, Leadership, and Management from the School for International Training in Brattleboro, Vermont. She is committed to addressing the deeper societal causes—poverty, structural violence, environmental destruction— of poor health in her post-graduate work.
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