ORGANIZATIONAL DEVELOPMENT OF MEDICO FRIEND CIRCLE A BRIEF OVERVIEW (JAN 88)

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ORGANIZATIONAL DEVELOPMENT OF MEDICO FRIEND CIRCLE A BRIEF OVERVIEW (JAN 88)
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A BRIEF

OVERVIEW

(Jun188)

INTRODUCTION

This note is primarily meant for prospective core-group
members to appraise them of the organizational development
and status of MFC.
But it will be useful for the current
core-group members for the purpose of self-clarificatiori
and for discussions on organizational policy matters in
future□
It portrays the evolving process of our develop­
ment and explores our strengths/ our weaknesses and the
opportunities as well as the threats to further growth.
This note is a supplement to the printed leaflet
which briefly gives an introduction of MFC. This note is
also an attempt at an internal audit and must be read in
that light.
It is hoped that it will challenge all of us
to think about the future more creatively.

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The Role of MFC

1.1.
In the initial period after the formation of
M.F.C., there was a substantial amount of debate both in the
pages of the MFC-bulletin and in several group discussions
about the role of MFC.
The debate in the bulletin has been
included in the anthology 3 HEALTH CARE, WHICH WAY TO GO ?
and it is worth going through this debate and the consensus
that emerged at the end of it.
Only a very brief summary is
attempted here;

The founders of MFC ( the original 1 core group’
of
1973/ which had links with Jayaprakash Narayan and the Bihar
Movement ) were primarily motivated to aid the process of
fundamental socio-economic and political change. On account
of this motivation/ they invited and were joined by other
1 medico-friends 1
(not all doctors)
of liberal, Marxist
and other background.
Therefore, in the initial Annual Meetings, the discussions were very directly overshadowed by
this consideration of social revolution. What is more impor-tant, the content of the discussions tended to rapidly
gravitate to economico-political issues. This resulted in
disastrous consequences, viz s

i) younger newcomers like medical students
thought that MFC was a sort of platform
for political debate, perhaps a recruiting
ground for political organizations and
they had not come to MFC for such things;
ii)

for health activists no concrete programme
in the health field could emerge from the
discussions and in that sense, these
discussions were sterile; and

iii) since MFC consists of people from various
political / ideological backgrounds, there
was a danger that political debates would
eventually lead to the splitting of MFC
into many groups, without any advantage to
the health-movement. The concept of a
friends circle would also be in danger.
( Contd

After mugl'i- debate, introspection and also after paying a
price in-terms of the disappointment of many new comers....
etc., we dedided at an important meeting in Sevagram in 1979
that in MFC we should focus on Health-issues and include the
directly and concretely relevant socio-economic-political
issues involved without getting entangled in the general
economic-political issues and debates.
The newer pamphlet
( 1981 ) meant to introduce. MFC’s general perspective to
the newcomer, reflected the minimum common understanding
of MFC about the health system.
1.2
Attempts were made to make MFC active orga-nizationally to lobby for certain reforms in the medical
system and to critically respond to government’s initiatives
or the lack of it, on health-issues.
But there were many
problems^ Most MFC-members are so involved in local work
that they do not get much time for MFC1s Organizational work.
India is a vast country and social conditions are such that
for any change to occur at the national level, a great deal
of organizational mobilization is required.
At least for
the present, MFC-members.are not in a position to function
even as an effective watch dog body at the national level.
It is, as of today, primarily a platform of like-minded
critical health activists and a
’thought-current.’
This in
itself has a kind of an impact in health circles; but that
is all 11
1.3, Attempts were made and are being made to form
a loose
’MFC-group’
at a local level, by taking up some
collective action from MFC-perspective at the local level.
In the earlier period, regional study camps to study, a health
issue through field vnrk helped to consolidate MFC-identity
at regional-cum-local level. The ‘Rewa-Camp’
conducted in
1978 to analyse ths problem of Lathyrism in all its aspects
was a successful, self-educating experience.
But unfortunately
such efforts were not repeated later.

2.

The Core-Group

The core-group is 'only an informal group of MFC
members who are concerned about and work for the growth of
MFC.
it is also a friends-circle and a platform for full
fledged heated debates and warm exchanges ’
•
The ’criteria1
for requesting a member to become a part of the core-group,
is that the member must have attended at least one annual meet so that all core-group members meet him/her in person,
and atleast somebody in the existing core-group should know
the person well enough to be able to judge whether he/she
can fit into the current
’culture*
of the core-group heated debates, yet getting along together, learning from
each other and also being able to face the not so pleasant
organizational weaknesses of MFC. Any core-group member
who does not attend two consecutive core-group meetings, or
annual meetings without even writing to the Convenor auto­
matically drops out of the core-group.

MFC badly needs more core-group members—those who
would spend time and energy for MFC’s organizational growth.
Duo to the all round steep increase in the costs, running of
the bulletin and maintaining MFC’s Offices (now three 1 ) has
become more and more difficult - lack of money and lack of
human-power has almost threatened the very existence of MFC.

(Contd •..

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3• Rclo of Annual-meets and Core-group meets

This issue has been' a very important iseue right
from the beginning since apart from the Publication of the
bulletin, annual meets and core-group meets are the only
two other regular collective activities of MFC.
In the initial years, the annual meets were seen
as mainly to expose interns and the like to MFC, its persp­
ective; and also to consolidate MFC’s general perspective.
As time wont by, most of the core-group members ceased to
have any link with.the medical colleges and hence there were
now not many interns in our contact circle.
Secondly, due to
the Shibir like Annual-meets# the old members did not get
anything new to learn.
Similarly many new MFC-members were
persons who had some expertise or experience in the field of
health and they also did not like the Shibir like annual-meets
and experience showed that the collective knowledge, under­
standing of MFC was enriched by the new inputs from those
new members who had experience or expertise, in the field
of health. After a lot of discussion, it was finally
decided in a Core-group-meet in Hyderabad ( in 1983 ) that
influencing interns or housemen is.not the function of the
annual-meets.
This work has to be done at a local level by
core-group members.
The aims of the annual meets, as they
have emerged through experience and discussions are outlined
as follows :-

3•1• Annual Meets
To develop, share and enrich our collective under­
standing of the various aspects of the health system in India.
Somewhat wideranging topics should be chosen so that doctors,
health workers working in different aspects of health, new
resource persons, senior workers working in different areas
of health, would also come to MFC-meets, would know about MFC
in detail, and the MFC circle would broaden in different
directions.

meet in person, those individuals whom we have
met only through the bulletin or through correspondence.
To know each other1s experiences, ideas, feelings is an
important function of the annual meet. Conscious efforts
have to be made to see that the annual meet is not totally
dominated by the theme-discussion, but that getting to know
each other, making friends, broadening the circle also
takes place.
3.1.3
Forming a lobby-group, or collectively getting
involved in our action around an issue is not the aim of the
annual-meet.
To arrive at an ’action-programme1
as a
routine in the final session of the annual meet and then not
to follow it
( given the nature and limitations of MFC ) is
worthless as well, as frustating. We would, however, try to
arrive at conclusions ( which may be in the form.of divided
opinions also )
sc that something concrete emerges out of
the discussion.
Secondly, some areas for our further study
would also be outlined.
If some participants want to carry

out some action programme on the issue, that is most welcome;
but MFC is not in a. position tip take up ’action-programme ’
as
one of the aims of the annual-meets.
3.1.4 Getting to know in detail, the project or the insti­
tution which hosts the meet is not the aim of the
meet. There will, of course, bo a brief introduction,
but for those who want to see the project/institution,
separate arrangement should be made before or after
the meet with consultation with the hosts. Through
trial and error a distinctive mode of discussion at
the annual meet has been evolved. The Note s 1 The
aim and the method of discussion at the MFC annual
meets 1
gives some details regarding this.
3.2

Core Croup Meets : Initially, core group meetings were
dominated by debates about the role of MFC, evalua­
tion of earlier annual meet, organizational matters,
preparation of anthologies, arrangements for regional
camps, annual meets etc...etc.
It has been a friends’
circle and all sorts of issues were also debated.
Once basic things were sorted out, more attention
was paid to the content of the annual meet.

3.2.1

Apart from discussion on organizational matters, it was
thought that much more time should be given to the
discussion on the content of the coming annual meet.
A pattern has emerged s after the annual meet at
january-end, the topic for the next annual meet is
tentatively decided, a few persons take up the task
of doing some exploratory work $nd in the coming
core group meet, they present the main issues for
discussion.
These presentations and the discussions
about the issues give a more concrete idea about what
needs to be done to organize a good discussion in the
coming annual meet.

Recently, it was thought that we should write
a summary booklet based on the background papers and
discussions of the annual meets, since the material
and the discussions are generally of good quality.
For want of space, this material can’t be put in
the bulletin.
The booklet would reflect the consensus
of MFC
(if that is not possible, more than one view­
point would be reflected )
on that issue, drawing
liberally from the facts, figures, arguments in the
annual meet papers and discussions.
Somebody would
write a draft, to be circulated in advance amongst
core group members. After discussing tihe draft and
the comments, a final draft would be prepared, again
to bo approved by a committee of volunteers.
If there
arc any sharp differences of opinion, then they would
be clearly spelt out by respective persons.
•Alongwith somewhat indepth discussion of the
issue in the forthcoming annual-meet, indepth discu-ssion on the theme of the previous meet- would also
take place in the core group meet.
For example,
there was a very sharp and good debate on the issue of
critique of the National Tuberculosis Control
Programme.

3.2.2 The cere group meets were so dominated by discussions
;
on the annual meets and ^organizational {natters
that we fopnd that we had stopped sharing and
analysing our experiences in a systematic manner
—one of the main reasons why we are meeting
together 1
It was, therefore, decided at the
Khandala-meet in 1985, that we should consciously
devote a few hours during the mid annual core group
meet for seme systematic sharing of what each of us
. has been doing, what are the problems one is facing,
what has been the achievement etc. There will be
feed-back, comments, friendly advice etc., after
each sharing; but systematic, indepth discussion
would take place only on some issues / experiences
selected by the whole group.
Otherwise indepth
discussions can continue amongst interested indi-viduals, once initial discussion has taken place
collectively.

The mid-annual core group meet would,
therefore, consist of three days as follows ?(1)

Preparation for the coming annual meet-1 day

(2)

Sharing by core group members -

(3)

Discussion on the draft of the booklet
based on the last annual meet, or any
other theoretical presentation, draft
- h day

(4)

Organizational matters- 1 day.

day

Those core group members who want to see the work
of our hosts in some detail, would come earlier or
stay back for this purpose.
It is expected that
at least a few would bo interested in such a special
visit.
(The rest of the core group would of course
have a brief introduction to the project.)
If no­
body wants to see the project in any detail-, there
is not much point in going out of the way to a
corner for the core group meet. The Ashram at
Sevagram is quite a central and convenient place*

It is hoped that in the coming core group meets,
there would be a much more fruitful, indepth, syste­
matic discussion, sharing and interaction at the
individual level.

4 • Convenor- sh ip/Ed ito r sh ip, Ed i tori al policy s
ixl. MFC4 s Convenor and Editor change every two years or so.
This is an attempt at sharing the responsibility
in rotation so as to give scope for newer ideas
from different persons. Those who have been Conv­
enors or Editors have a first hand experience of
the woes of this work, and hence, a more sympathetic
and co-operative, responsible attitude develops
vis-a-vis the current Convenor, Editor. As time
goes by, the work of the Convenor is becoming more
or less of full-time nature. This is also true for
the Editor if he/she has to lock after the printing

and
the bulletin as well. Ways must be found
to reduce the burden of the editor and the convenor.
This is a dilemma which has not been solved.
Paucity
of members, lack of ^organizational discipline, lack of
funds -all have been knotty problems. Unless membership
and subscriptions increase, it would be difficult for
MFC to survive, let along grow, for purely financial
reasons.

4._2 The Editorial Policy has emerged through the experience of
last ten years.
It has now been formalized in a brief
note meant for prospective authors.
5. Funds"
5.1. MFC has always been short of funds.
Initially the losses
in the publication of the bulletin which was the most
important activity of MFC; ( Nov; the annual meets are
also as important) was about a couple of thousand rupees
a year. This was made good by collecting individual
donations from sympathisers.
But this loss has now
mounted upto Rs. 5000.00 per year. We got a donation of
Rs. 5000/— • twice from the Nutrition Foundation of India;
but this was only a temporary solution. Additionally,
the office-expenses of the MFC convenor and that of
the Rational Drug Policy Cell / registered Office are
also there. Unless we increase our subscribes and
members, we would not be able to survive without loosing
our financial autonomy.

5 .J2 The idea of having a full-timer for MFC and its financial
implications have been discussed several times. The idea
is s we come across so many people who did not knovz about
MFC and have immediately become members after knowing
about MFCZ reading the MFC-bulletin or anthologies.
If
a full-timer can travel around the country or a part of
it, to medical colleges, science and health groups,
institutions etc., we may get many new members.
But
this required :
i) a proper person who is both capable of and
willing to represent MFC;
ii) core group members should be able to help
such a full-timer by helping him/her own
area in various ways;

iii) funds from a proper source.

The last requirement is as important as the other two.
By and large, MFC has avoided taking outside institutional
fundsr The most important reason is unless the major part
of any movement1s activity, at or at least its core acti­
vity is financed from members and sympathisers or thro*
sale of literature..oooetc., outside institutional
financing tends to be harmful in the long run by pushing
back voluntary effort and voluntary commitment. MFC has
been an expression of a critical current in the health
field,of
’movement1
( understood in a broad sense ) and
if MFC starts becoming dependent upon outside institutional
funds, it may become an institution.
Such institutes are
likely ( thought not necessarily ) to degenerate into one
of those institutions which are run because there are funds
and paid full-timers, irrespective of the social need for
such an institution.

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5_-_3 Fully recognising ‘the possible danger of outside insti<■'
tutional funds for a full-timer, MFC twice decided
to take such funds on a temporary basis because
growth in the number of" members and subscribers has
become such a vital question. There was an explicit
condition that if after two years, there is no appre­
ciable increase in memberships and internal financing
to make MFC financially self-reliant, we would stop
taking such funds. Unfortunately in both the
instances, the individuals who had offered to work
as full-timers, withdrew their offer for personal
reasons.
5.4 Twice, MFC has taken funds from OXFAM (rs. 5000.00 and
Rs. 10,000.00 respectively) for its first two antho­
logies. There were no conditions set by OXFAM and
taking these funds has not affected MFC1s financial
autonomy or self-reliance. Though our anthologies
sell well, the proceeds of sale of these anthologies
are not always sufficient to bring out the next
anthology.
Funds for publications are thus going
to be a problem.
So long as MFC is serving a
socially felt need, is based on voluntary commitment,
funds from even a foreign funding agency like OXFAM
is not excluded. We reiterate that we are fully
aware of the problems and potential dangers of out­
side institutional financing especially from a
foreign source.

6_._ Administrative Cell 2

Since some organizational matters are primarily of
an administrative nature ( preparation of budget,
fulfilling official requirements.etc. ) it was
thought that there is no point in the whole of the
General Body or the Core Group to spend time on
such matters.
An Administrative Cell has been set up
since 1985, consisting of a few past convenors, the
present convenor and a couple of
’experts.1
They
meet prior to the annual general body meeting and
work out the details of some of the organizational
The
matters and present it to the general body.
General Body may modify their plans if necessary.
This arrangement for administrative matters leaves
more time for the general body to focus on policy­
issues or other important matters.

7. MFC1s Involvement s Bhopa1-Djsaster, Rational Druq
Policy Cell 2

7.1

Bhoftai g MFC’s involvement in Bhopal has been the only
collective organizational effort (apart from the
Bulletin and Annual-meets) of some major significance.
Several core group members stretched themselves to
the full to conduct two important studies on the gas
exposed people, to prepare educational pamphlets for
them and to participate in medical relief. The first
of these studies was the only published, community
based epidemiological study available on the over-all
health effect of the gas leak on the exposed population.
MFC can thus rise to the occasion and play an impo­
rtant role. But by and large, it remains a platform and

thought current.

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Rati^rTa'r'brug Policy Coll ? Concretely criticising irra­
tionalities i.n the production and use of drugs
and putting forward alternatives, has been one
of the activities of MFC-members. MFC has,
therefore, been an active part of the coming
of various groups interested in drug issues from
different parts of the country to form the All
India Drug Action Network ( AIDAN ) . The movement
for a Rational Drug Policy, has been one of the
rare examples of different groups coming together
on a health-issue and preparing a substantial
critique of the National Policy and an equally
solid, concrete alternative to it. MFC-members
have contributed to this movement by participating
in seminars, newspaper campaigns, lobbying with
the government and in the formulation of the
perspective of AIDAN.
A Rational Drug Policy Cell
has been formed to look after MFC's involvement in
this issue.
The two studios published by this
cell ( rationality studies of antidiarrhoeal and
analgesic mixtures) have been found.to be very
useful in the drug-campaign.
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8• Modalities to represent.and pursue work on behalf of MFCs
There is lots of action and campaign going in the
health and related field in India, in which MFC
either at local/regional or national level is
required to or is asked to participate. Core group
members are always in dilemma what to do in such
a situation ? Is MFC simply a thought current,
and no active participation is possible or MFC
should respond to these issues if there is possi-bility ? Local MFC group may participate in such
activitieso
It is understood that core group members are those who understand the ethos of MFC
and would not take any decision contrary to the
traditions and perspective of MFC.
It is in this
spirit that following norms were decided in the
core-group meet at Wardha in June, 1988 s
When an individual or group of MFC core
Group members fool the need or are requ­
ested to represent on the committee, he/
she may do so and inform the convenor.

1)

; 2)

If the issue is of national or regional
importance then also he/shc can take action,
but it will be discussed in the next follo-wing core group mooting and the members
should bo present for consultation.

3)

If there is difference of opinion, local
-group will act in trust given the autonomy .
of the group.
Simple majority decision
will not bo the criteria for rethinking.
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be or not to be s MFC has survived many crises and that
reflects its inner strength.
But recently, once
again d&ubts have been raised about the very
existence of MFC because of -

i)

stagnation in subscriptions & membership
at a very low level, making it oven
financially difficult to continue;

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ii) l^feeling tnat the ofljginal aim of aiding
the social revolution jis not being served
(social revolution is/not around the corner
as was once thought !,) Many core group members have developed their own areas of
creativity and involvement; and do not
really gain anything from MFC—this is
shown in declining participation and
enthusiasm in even writing for the bulletin
and all other MFC-matters;

iii) new members are interested only in a parti­
cular theme of the annual meet; and not in
the organization.,
Hence, there is a vety
high turnover rate of new members.
It was,
therefore, suggested that MFC has outplayed
its role and there is no point in continuing
only for sentimental reasons.

This suggestion, made by a core group member in a letter to
the Convenor before the recent mid-annual core group
meet at Pachod in July187, was discussed seriously
at this meet.
It was agreed that the above argument
is true to a certain extent, but there are the
following counterveiling reasons for which MFC has
a definite role to play and WQL.need_ to continue to
exist as an entity slo... MFC has, over a period of twelve years,
developed a very healthy tradition. Doctors

2RS

agUyigts from different ■ -

ideological backgrounds have debated, shared
their ideas and experiences from a pro-people
perspective.in a non-sectarian and non-dogmatic
manner and have developed a feeling of solidarity
despite continuing differences. Very critical,
honest, informal, indepth discussions on socially
vital health issues by people who are themselves
engaged in health action at grass root level is
an achievement in the context of the presently
prevailing overall socio-political culture in our
country of opportunism, short-sightedness, and
sectarianism,.
It would be wrong to liqu date
such a tradition.

2.... Many activists, look upon MFC as a source
which would give them a critical, non-medicalized
view point about different issues in health. The
Bhopal-studies have underlined the important role
MFC would play.
There is a social need for such
a group to continue. The Convenor gets scores of
letters from new members who are thrilled to know
about MFC, its perspective, books and who readily
join MFC.
Though MFC would not grow the way it did in the
initial years, it continues to get now members and even core
group members.
Ndw core group members also expressed the view
that they found MFC to be a very stimulating, useful, serious
honest platform.

Therefore, it was, decided to continue though
with our fingers crossed
‘’
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