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ASIAN COMMUNITY HEALTH ACTION NETWORK
ASIAN CONSULTATION
19-27 JANUARY, 1999
HOTEL GRANDE VILLE, BANGKOK, THAILAND
Objectives
ACHAN (Asian Community Health Action Network) held a series of
consultations with their strategic partners, 19-27 January, 1999, to
evaluate the current global trends in the light of the growing
integration of national economies, the loss of sovereignty of national
governments and their selective effects on the poor of the world
ultimately reflecting on their health. The IMF-WB (International
Monetary Fund - World Bank) combine has forced changes in national
health policies, giving low priority to primary health care and
advocating cuts in social spending. These Consultations were
organised to evolve strategies to counter the threat of globalization on
the poor.
Since globalization has been identified as the main threat to the health
of the poor of Asia, ACHAN brought together strategic partners from
ten Asian NGQs with the time, space and motivation to involve
themselves in countering the effects of globalization with the
objectives of:
•
Helping NGOs (Non-Govemment Organisations) to understand
the effects of globalization and to identify strategies to counter it.
•
Evolving appropriate strategies to safeguard and promote the
health of the poor
•
To formulate a concrete agenda and a joint plan of action for
ACHAN and its partners.
ACHAN has always believed and used training as a tool for social
transformation. With new threats to the poor emerging, training must
build capacities of NGOs and communities to cope with these changes.
Training needs to be used as a strategy for enabling communities to
understand the changes around and the reasons for them and to counter
the factors that affect them adversely. The objectives of the Asian
Master Trainers Workshop, 22-24 January were:
•
to evolve training strategies appropriate to the context of
globalization
•
develop a training module on globalization for use by our
partners.
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CONSULTATION, 1999
1
The two workshops were followed by a consultation of Advocacy
partners. The objectives of the Advocacy Workshop were:
to determine the advocacy status of the partner NGOs
identify needs and gaps in advocacy work,
set up a system of coordination among advocacy partners of
ACHAN and
to develop an advocacy agenda at the country level.
•
•
•
•
Summary ofAchievements
Strategic Partners Meet achieved:
• A clear understanding of the realities of globalization and its
effects on the poor
• A commitment to a joint plan of action
• An affirmation to build coalitions at the national level
• Play an active advocacy role - with national governments
Asian Master Trainers Workshop helped:
• Develop training strategies to capacitate NGOs
• Develop a training module on globalization
• A commitment to train partners in all the countries under reference
Advocacy Consultation:
• Identified gaps in advocacy work, nationally and regionally
• Resulted in focusing on a single, fundamental and important
issue
Synthesis of the three ACHAN Workshops
The first workshop resulted in a mutual reaffirmation of commitment
between ACHAN and its strategic partners. It rekindled the spirit of
unity in the struggle against ill-health, poverty and foreign oppression.
It culminated with a vital document. The Bangkok Declaration,
which embodies the analysis, perspectives and aspirations of
representatives of 22 participating organizations. All agreed to
counter the effects of globalization, to genuinely promote people’s
health and to work together based on the principles of people-centered
development in health in the Asian region.
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ACHAN
Specifically, we resolved the following:
On Networking:
• To re-vision and re-mission our NGOs in order to better focus on
countering the effects of globalization that are causing the
deterioration of people’s health
• To expand our network to others and possibly build coalitions
united in our efforts in countering globalization.
On Training:
• To incorporate the effects of globalization in all training designs
• To make training as a strategy to empower the people.
On Advocacy:
• To launch a campaign on globalization and its ill effects on poor
people’s health
• To reaffirm that primary health care in state responsibility and to
present state recognization this
• To continue strengthening networks through information systems
• To identify and embark on different methodologies that will put
people’s health issues in the public eye
• To come up with a joint program of action in pursuing our
commitment
• To build an alternative development paradigm of health.
Tasks ahead
ACHAN needs to build a perspective for its constituent NGOs on
issues concerning globalization. There is a need for training to create
awareness and build competence of communities to counter
globalization. People’s organizations and movements must be
involved in all actions. Promotion of alternatives in health,
particularly indigenous knowledge is pertinent. The ultimate aim is to
create people’s resistance movements at all levels.
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CONSULTATION, 1999
3
Note:
In order to better understand our plans for the future as well as
to have clarity on the material at hand it is important to take an
in depth look at some of the fundamental principles and
stratergies of ACHAN. The following is from the ACHAN
proposal for action for the period 1999-2001.
Focus
For ACHAN therefore, the focus would remain unambiguously on the
poor of Asia and on their health.
Vision
We aspire for a society that is just, participatory, pluralistic and
peaceful, where a dignified living sustainable within people’s own
resources and within the resources of their immediate environment can
be secured for all people without fear or discrimination.
Mission
Our mission is to capacitate the NGO sector involved in health care of
the poor in Asia in: i) the values and norms of an alternative society,
ii) knowledge and skills in implementing people-based programs, iii)
developing a cadre of informed, capable young people who will be
involved with the poor, iv) developing organisational structures
appropriate for the.‘clientele’ and the task ahead and v) building
solidarity among them and among their national networks.
Strategies
Our strategies are aimed at two specific groups of people involved with
the health of the poor: first, the NGO sector and the second, decision
makers and policy makers such as international and regional health
agencies, ministries of health and resource agencies.
In brief, these strategies focus, on three specific thrust areas:
Training
Advocacy
Networking
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ACHAN
These thrust areas emerged as a result of an extensive participatory
reflection process that took place in the last eighteen months and
involved various levels of what can be termed as other ‘stake holders’,
a term currently in fashion, including and specially, communities of
the poor in five Asian countries.
Networking
Advocacy
Training
Advocacy
Networking
In many other programs, these circles (Figure IF) may not even
converge. In fact, they may not be even of the same size denoting their
priorities in terms of time, effort and resources. But in such a state, the
left hand may not know what the right hand is doing and therefore
finally be largely ineffectual. Therefore, ACHAN will strive to reach
a stage where our activities will be of equal proportion and converge,
like this (Figure III):
Figure III
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CONSULTATION, 1999
5
Our aim will be to keep enlarging the central area of convergence
{shaded area here). Our central or core activities will be those which
emerge out of here. This is the synergy producing area. Synergism is
defined as the interaction of elements that when combined produce a
total effect that is greater than the sum of the individual elements. This
is what we expect the complementarity of our three thrusts to do.
Ultimately, we hope that it will look like (Figure tv).
and within
that is Training
which is central
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A CHAN
Within that is
Advocacy
ASIAN COMMUNITY HEALTH ACTION NETWORK
(ACHAN)
BANGKOK DECLARATION 1999
It is the fundamental and basic right of every human being to live a
dignified life without any sense of guilt or fear, without being
oppressed, and experience physical, mental, social and spiritual
wellbeing. Human health is central and both a determinant and product
of the above tenet. Some key provisions in the constitution of WHO
state that health of all peoples is fundamental to the attainment of
peace and development; that the informed opinion and the active
participation of the public are most important in the improvement of
the health of the people; and that governments have a responsibility for
the health of the people by the provision of adequate health and social
services. However, at present, the world is experiencing a period of
growing deprivations, inequalities and injustice towards the poor
particularly women and children. The impact on human health of this
has been enormous in terms of wasted human lives and setbacks for
development.
With the above concern, we the participants in the meeting of the Asian
Community Health Action Network (ACHAN) hereby solemnly
commit to the following declarations;
1.
We resolve to unite, act, and actively advocate to reject the current
globalization trends, as they stand today because:
*
Globalization is purposefully defined, glamorized and
aggressively imposed to justify and even legitimize unequal
relationships among peoples and nations.
*
Globalization is a new and sophisticated form of colonialism with
multinational corporations setting conditions for policies,
decisions and choices. Socio-economic dominance has rapidly
accelerated the process of making the rich richer and the poor
poorer.
*
The so-called liberal economy prescribed with globalization has
increasingly made countries susceptible to imbalances of trade,
ASIAN
CONSULTATION, 1999
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severe indebtedness, addiction or dependence on foreign aid,
economic crisis or even near bankruptcy and economic collapse,
mainly resulting from monopolistic marketing practices and
unjust appropriation of resources. Similarly, globalization
imposed, incapacitates people, making them lose their
sovereignty, subservient with colonization of their minds. It also
degraded quality of life and environment, increased risk of
unemployment, ill-health and even suicide.
*
Globalization is systematically shifting the ownership of natural
resources from the people especially of indigenous/tribal
populations, to corporations and from nation to regional or
international conglomerates.
*
Globalization is directly and indirectly eroding human value
systems, people’s and nation's freedom, sovereignty and dignity
by minimizing the role and responsibility of the state towards the
people by imposing export oriented trade, tariffs, capital flows and
taxation.
*
Globalization, now unjustly patronized by WTO, has seriously
threatened food security with massive shifts in agriculture towards
cash crops. This has resulted in massive increases in malnutrition
and hunger.
2.
We resolve to act to counteract and to correct the internal factors
that are promoting such globalization in its current form by
causing:
*
An upsurge in professional irresponsibility with a shift towards
profit motives, the commodification of health, unethical practices
and indifference to threats affecting life and health of the people
they serve.
*
A rise in corruption,
*
Government insensitivity in their political and social commitment
towards the needs of the people, and social accountability, and
*
Shifting the role of the public sector to the private sector.
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ACIIAN
3.
In order to set things right, we resolve to counter globalization and
totally replace with a new concept in a different perspective that
puts people, social justice for poor people, equity and a peopleoriented development first, so that:
*
Knowledge, information systems, human rights and other gains of
human civilization do not serve the vested interests and groups nationally and internationally.
*
Resources and development gains are more fairly distributed.
*
Countries and people generate and develop the needed
information to facilitate informed decision.
*
All countries and people of the world have access to channels and
means of communication needed for their development.
*
Human development programs and processes are people-oriented
and at the same time environmentally friendly.
*
The identity and interests of minority and Indigenous People, their
language and their socio-cultural setting are not overrun.
4.
We will educate all concerned to foster development of a more
wholistic health with a special focus on the health of the poor,
women, children and those deprived for which we pledge to take
health as:
*
Wholistic and indivisible.
*
A human right and a responsibility of all.
*
A development issue to be taken beyond the biomedical and
public health parameters and also related to the provision of basic
minimum needs, empowerment of women throughout their life
cycle, a stable and sustainable development of eco-system and
environment, social justice, recreation and human rights
(including civil, political, economic and cultural rights)
*
An area to be safeguarded from aggressive national and
international trade practices, unjustified and unethical
advertisement and promotion of tobacco and alcohol products,
non-essential drugs, and junk food items.
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CONSULTATION, 1999
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*
An area also concerned with the development societies free of
violence, torture, sexual assaults, human trafficking, bonded-labor
systems and child-labor.
*
An opportunity for the choice and development of alternative and
traditional care systems including ethnomedicine.
*
An enhancement of the quality of life (QOL) with provision of
basic-needs of the people, and primary health care as defined by
the Alma Ata Declaration.
5.
We strongly affirm that equity and social justice are key to the
health and well-being of the people, and we also believe that:
*
Equity and social justice are based on the principle that those who
need most should get most, thus justifying ACHAN’s focus to the
poor, women, and deprived populations.
*
Health rights are to be taken up rather than bestowed or given to
the people as charity. There is thus a need to conscientize the
people to develop solidarity among them and enable them to assert
their health rights. People are to actively participate in the socio
political and economic affairs and decision-making process
starting from their family to the national and international levels.
*
Politicians, legislators, judiciaries, policy-makers, decision
makers, health and related professionals, health providers and
frontline health workers should be more socially and
professionally responsible and accountable for the progressive
development of more equitable health policies with active
participation of the people.
*
Existing pro-people movements need to be further developed and
strengthened.
6.
We resolve to work and contribute to redefine the development
paradigm to make it encompass human development and have it
incorporated elements of human values, equity and social justice.
We also resolve to campaign actively to:
*
To ban secret or non-transparent, and unethical research affecting
human lives, environment and peace.
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ACHAN
*
To oppose the misuse and manipulation of statistics or information
to justify conditions perpetuating disparity, segregation or
deprivation of peoples.
In summary,
We advocate the promotion of a people-centered localized
approach to develop and improve health, protect and develop existing
and traditional knowledge and skills, and expose and counter the
negative elements of globalization as experienced in Asia and the rest
of the world.
Such localized approaches will build on the felt-needs and
demands of the people giving them a lead role in shaping their own
destinies.
As members of ACHAN, we pledge to work together and be
committed to the principles of people-centered development in health
in the Asian region.
January 21, 1999.
Bangkok
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ACHAN Strategic Partners Meeting
19-21 Jan, ‘99
Introduction and welcome address - Dr. Kawahara
Dr. Kawahara welcomed the participants and expressed his happiness
at seeing some familiar and many new faces.
Introduction of participants - Edelena del la Paz
The participants introduced themselves in a participatory manner
facilitated by Edelena.
Introduction to ACHAN - Prem Chandran John
Health programs need to shift from a service delivery mode to an
enabling one. Any worthwhile community health program must
enable the community to be self reliant. The spread of community
health has not been wide. Participatory training methodologies,
participatory' learning methods and participatory strategic planning
need to be propagated
In India the health status of the poor has been threatened by external
factors such as globalisation. In this context we need to see whether
NGOs are upto the task of equipping communities to resist
globalisation. The focus of NGOs should now be to protect
indigenous knowledge, place special emphasis on vulnerable section
like women and safeguarding common resources.
Objectives of the Workshop - Edelena de la Paz
•
Identify appropriate strategies for Asian NGOs to promote the
health of the poor in coordination with ACHAN.
•
ACHAN has identified globalisation as the main threat to the
health of the poor. The challenge before NGOs is to understand
the effects of globalisation and identify strategies to counter it.
•
A concrete action agenda on globalisation needs to be formulated
for ACHAN and its partners.
Keynote Address - Dr. Debabar Banerji
With ACHAN, he shares a common commitment to the poor. He
would like to be a doctor to doctors. Doctors are sick and we must find
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ACHAN
a theological diagnosis to look at medicine as a whole. Health is a
product of social, economic and political forces. In all our countries
we had systems of coping with ill health. The colonisers utilized
different mechanisms such as having English as the medium of
communication, to suppress all other systems of knowledge. Cultural
arrogance and ethnocentricism negated all other knowledge. Only 3%
of Indians speak English and control 97% of the country.
Inspite of all difficulties, Asia has made valuable contribution to the
world’s health system. Three significant contributions made by India
in the treatment of tuberculosis are:
In the 1950s, research revealed that home treatment is just as effective
as hospitalization in the treatment of tuberculosis. Research from
Chengleput proved that BCG has no protective value for adults. The
National Tuberculosis Institute in Bangalore found, in the 1960s, that
people believe in rational treatment for tuberculosis and they do not
have to be chased for treatment as the DOTS program has
contemptuously assumed.
Enlightenment and rationality are not important to the West when their
economic and political interests are at stake. The English language has
been used as an instrument to impose Western knowledge on Asians.
In the pre tigerisation phase in South East Asia, there was a complex
and workable indigenous health care system. This was completely lost
in the tiger phase when stress was given to the development of tertiary
health care. In the post tiger phase, people have no resources to spend
in tertiary care and they have also lost their indigenous knowledge to
take care of minor health problems.
The immunization programs are a fine example of how health
programs are designed to suit the economic interests of the West. No
serious evaluation has been done on the effectiveness of the programs
and more of these are daily imposed on the developing countries.
Programs are decided arbitarily, for example, the pulse polio program
was decided by the Rotary International. Lack of information is a
political tool. In India, there is no reliable data of births and deaths.
Rulers do not want to be embarrassed by such information.
The responsibility of NGOs is more since governments are
increasingly controlled by multilateral agencies. The myth of the
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global village is propagated whereas in reality we are only asked to
join it as bonded labour of ‘cowboys, landowners and kulaks. Asking
for globalisation on equal terms is like asking a tiger to be a vegetarian.
China had come out with excellent ideas in health care, like the
barefoot doctors scheme in community health which incorporated the
traditional systems of medicine. This was the essence of the Alma Ata
declaration - start with the people, find out what people do when they
are sick, and develop systems appropriate to them. But these systems
were allowed to deteriorate over time. People are punished for
determining their own health.
Globalisation is an old phenomenon and started with the Opium Wars
and continues today under various guises. WHO, WTO, WB,
UNAIDS, etc. are all agents of control. They took away decision
making powers from the state. Immunization programs have received
massive funds because of the biotechnology industry. It is the market
which decides what the problem is and what the solution should be.
The structural adjustment programs in various developing countries
have involved sharp cuts in budgets for the social sector. Privatisation
has been promoted in an unregulated way. WTO decides on the health
agenda. In the tigerisation phase, in Malaysia, there was a stupendous
growth of curative services at the cost of plantation services. Now,
30% of the beds are unoccupied. Diseases are manufactured to suit the
market.
WHO’s vision for the 21st century is renewal of health for all,
increasing involvement of the private sector, greater use of emerging
technology and vertical programs on a global scale. But why renewal
of health for all when this has been on their agenda for the past thirty
years . How is it possible to have programs on a global scale when the
globe is so diverse? This fits into Milan Kundera's picture, “Man’s
struggle against oppression is a struggle between memory and
forgetfulness”.
A survey on the utilization of medical care in India revealed that 90%
of people use allopathic medicines and only 10% use traditional
medicines. People’s health systems are emasculated. They are
resorting to quakes because of their helplessness - they have lost their
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ACHAN
own mechanisms for coping. Expenditure on medicines is the most
important reason for rural indebtedness in India.
Open Forum - Comments
In Asia, there are three concerns: As states we must either find a place
in globalisation or follow an alternative model. This is the political
agenda. Voluntary agencies must shift from a social paradigm to a
political social paradigm. Voluntary agencies are dying because
government are making regulations for them.
Our society has been eroded by the ruling classes for hundreds of
years. Globalisation cannot be blamed for the lack of health, water and
education in our villages. The brown man is the worst colonist. Let
them not find excuses in globalisation. Our ruling classes are
exploiting us. Our struggle is with our own people.
The linkage between health and education is ignored. There are is
many indifferent people around us. NGOs have not reached that
critical mass where they can lead mass movements.
People’s struggle against oppression is to remind the oppressor. We
need to have the intellectual capacity to confront the oppressor. The
Independent Commission on Health in India and Citizens Report on
Floods are some such efforts. Sacred cows need to be challenged.
Oscar Wilde as sang, “The worst crime you can commit is to leave a
person alone in his thinking.”
Workshop I
Identify factors and processes responsible for the deteriorating health
situation.
Key features of Globalisation are:
•
Technology as an instrument of control
•
Imposition of a particular knowledge system over all others.
Indigenous knowledge is vandalized.
•
Transfer of power from nation states to multilateral agencies and
multinational corporations resulting in crisis in food security,
detereoriating food security and decreasing space for the poor.
•
The response of the NGOs has been inadequate.
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CONSULTATION, 1999
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Guide questions for small group dicussion:
Given this scenario, how have we as a collective force in Asia
countered these dehumanising structures and decision making
process?
•
Identify issues based on country situation, trends during the past
ten years with focus on women, children, environment, health,
etc., what are the changes brought about by globalisation.
•
What are the responses of NGOs to the changing situation, how
have they repositioned themselves
•
Where are the gaps in our actions
Groupings
Group I - India
GroupII - Sri Lanka, Bangladesh, Nepal
Group IB - Philippines, Indonesia, Vietnam, Laos, Japan
Synthesis of Workshop I
I Country Situations: Issues
External Factors
• Imbalance of trade leading to economic crisis and widening the
gaps between the rich and poor nations
• Colonization of the mind
• Loss of empowerment, sovereignty and independence
• Subversion of people’s interests to multinational corporations
Internal Factors
• Subservience and colonial mentality
• Corruption
• Conservative societal structures
• Government insensitivity
Effects of these factors on the Poor
WOMEN - Triple burden of child rearing, household work and
economic work increased, unemployment, lacking skills to cope with
new technology, forced to work as migrant labour
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CHILDREN - child labour, malnutrition, poor education
ENVIRONMENT - increased pollution, unsustainable exploitation of
natural resources
AGRICULTURE - shift from food crops to cash crops affecting the
food security of the poor, unsustainable practices in agriculture
SOCIAL - disintegration of the family caused by economic insecurity
HEALTH - deterioration of traditional health systems, privatisation,
complete negation of Alma Ata
II NGO Responses to Globalisation
• Education/training - educating policy makers, conscientization,
information dissemination, skills and capacity building,
empowerment
• Networking and alliance building
• Policy advocacy
• Human resource development
NGOs have not addressed the actual issue of changing or controlling
economic trends
NGOs have not questioned export led growth models - they have
reacted but not acted
III Gaps in NGO Action Identified
There is a lack of clear vision among the NGO community. NGOs
need to share information in order to be effective. NGOs have not
networked due to insecurities and external factors. There is a lack of
ideological commitment from most NGOs. Some are also lacking an
assertive attitude. Less access to policy making and not playing an
advocacy role with policy makers.
Organisational Change Processes
Presentation of case studies by CHAI, VHAI, IPHC, RECPHEC,
ADAB which demostrates changes in organisational structures and
policies in the light of globalisation.
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Catholic Health Association of India - Fr. James Culas
Catholic Health Association of India (CHAI) is one of the largest
actors in the health sector. The majority of the membership are small
health posts run by a single nurse sister providing simple health care
for mother and child. A shift in philosophy occured with communitty
health being identified as the first priority. This was defined as ‘a
process of enabling the people, especially the poor and the
marginalised, to be collectively responsible to attain and maintain their
health and to demand health as a right.’ The strategy to implement this
involved, decentralisation, bottom up approach and networking with
the government and voluntary agencies. Advocacy was perceived as
an important tool and the concept of the District Health Action Forum
was mooted.
Tamil Nadu Voluntary Health Association - Saulina Arnold
Tamil Nadu Voluntary Health Association (TNVHA) has been
involved in issue based networking, capacity building of voluntary
agencies and their staff, publications, networking and advocacy. They
work in active cooperation with the government, critiquing it at the
same time, and modifying government programs to suit local need.
They have changed their earlier policy of being aloof from the
government which they feel is a futile exercise.
Institute of Primary Health Care - Luz Canave-Anung
Insitute of Primary Health Care (IPHC) is engaged primarily engaged
in training health workers, enhancing agricultural productivity and
gender and reproductive health. In the- late 1970s, with a view at
promoting holistic development, they started the sustainable Integrated
Area Development Program.
Resource Centre for Primary Health Care - Shanta Lail Mulmi
Resource Centre for Primary Health Care (RECPHEC) was part of the
movement for establishing democracy, freedom and constitutional
rights in Nepal. RECPHEC’s main areas of interest are policy
advocacy, sensitization and awareness raising activities, consumer
rights and consumer movement and information dissemination through
publications. With Nepal coming under the umbrella of globalisation,
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RECPHEC has been campaigning against the tobacco industry and
looking into aspects of globalisation and poor people’s health.
Association of Development Agencies in Bangladesh -ABM Shamsul
Huda
Association of Development Agencies in Bangladesh (ADAB) is a 900
member organisation started during Bangladesh’s struggle for
independence. After the participatory strategic planning process, all
members endorsed certain programs for AD AB. These include
programs to strengthen the democratic institutions in the country,
create awareness on the impact of globalisation on women and
children and evolve a stable relationship with the government.
Sarvodaya - Dr. Vinya Ariyaratne
Based on the Gandhian ideal of self help and self reliance, Sarvodaya
stresses saving and credit programs and community organisation. The
challenges they face are operating under conditions of civil war and in
the light of globalisation protecting their programs from interference
by the World Bank or the Asian Development Bank.
PERDHAKI - Dr. Felix Gunawan
PERDHAKI is the coordinating body of Catholic health organisations
in Indonesia. Their programs include primary health care, medicine
supply, pastoral care and training of volunteers. They also work
towards religous harmony in areas of conflict. During Suharto’s
dictatorship, the government had a very hostile attitude towards NGOs
but now they have opened up and NGOs will change course now.
Responses to the Case Studies
While organisations have changed over time, they have not taken the
global changes into consideration. There is a need to balance
actionism and activism. NGOs have become service delivery
organisations. These policies of NGOs have not changed.
Is VHAI legitimizing government programs by participating in them?
VHAI as a nodal organisation inspite of all its shortcomings has taken
up national issues which is a substantial contribution. VHAI took
initiative to analyse programs like Tuberculosis. Voluntary agencies
must pool their resources.
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CONSULTATION, 1999
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Working with the government is a dilemma. Some NGOs work with
the government because it gives them stability and they feel they can
change government policies this way. Taking money from the
government makes NGOs accountable to them. Also, NGOs cannot
ignore the existence of government. But relationship with the
government must be well defined. Development is a political process.
Hence NGOs need to have a political stand.
Roles that have Emerged
• Networking is the key factor to effectiveness
• Need for accessing information, interpretation and dissemination.
Information to be used for advocacy
• Research role
• Influencing the media and creating public opinion
• Training and capacity building at the macro level
There is a good balance between what roles partners can play and what
roles ACHAN can play.
Workshop II
Guide questions
1. Elaborate on the gaps in actions identified in the previous
workshop and show how these gaps are to be bridged at the
country and Asian level.
2. What will be the role of ACHAN and what is the expectation from
ACHAN
Roles For ACHAN
• Counter legislation that affects the health of the poor such as the
legislation in India which equates the voluntary sector with the
private sector in health delivery
• Promote people’s health forums to address local health issues
• Act as a health resource information centre: facilitate data
generation, interpretation in the light of globalisation and
disemmination of information, documentation of successful health
care models
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ACHAN
•
•
•
•
•
•
•
•
•
Conduct research studies on: impact of the South East Asian crisis
on the health of the poor, alternative systems of primary health
care
Capacity building through trainings
Facilitate partnership among members
Be an advocate among donors
Act as a health resource information centre
Work with interested national level NGOs
Collect case studies of initiatives
Advocacy role: promote the Asian perspective on health, policy
making at the country and Asian level
Build national alliances at the country level and a regional alliance
at the Asian level in order as a mechanism to formalise the
arrangement
Action Plan
What is expected of ACHAN ~
• Be an aggressive network
• Shared idea of health
• Membership to only those sharing this vision
• Facilitating data generation and dissemination, eg, economic
meltdown
• health research information system to mainstream successful
alternatives
• Advocacy role among donors - bring them to a common
understanding
• Facilitate partnership among members
• Capacity building, including funds for module development
• Network or secretariat for the network - What is the role at the
country level and Asian level
ASIAN
CONSULTATION, 1999
21
Dilemma
• In terms of membership, to what extent do we represent the issues
of our membership?
• While the network may have one philosophy, members can have
their own concerns which ACHAN cannot address
• There is a need for a common minimum program for the
membership and all other programs must comply with the spirit of
these
• Pooling together common resources
• Need for a mechanism for coordination at the national and Asian
level
Tasks Ahead
•
Perspective building for NGOs in the light of globalisation
•
Training to create awareness and competence to counter
globalisation
•
Providing information to different actors to equip them to counter
globalisation
•
Advocate a single issue
•
Involve people’s organisations in all actions
•
Promote alternatives in health, particularly indigenous knowledge
22
ACHAN
Asian Master Trainers Workshop
22-24 Jan, ‘99
Welcome address - Prem John
The role of trainers is crucial to the transformation process. In the light
of globalisation, the strategies adopted for trainings and the process
itself will have to undergo changes. We hope to arrive at strategies to
counter these trends in the course of this workshop
Objectives of the Workshop - Dr. Abigail Tauli
ACHAN has been involved in training for the last ten years. Now after
a series of internal evaluations the focus is now on the issue of
globalisation. We need to develop strategies to counter the trends that
affect the health of the poor.
Expectations
• Develop training perspectives
• Training in the context of globalisation
• Needs assessment for training
• Community based alternative training methodologies
• Evolve action plan for training
• Define role of training in ACHAN as a network
• Discuss ACHAN’s role as a support system for training
• Strategy for fund raising.
Strategies for Training
Organisational Strategy
Objectives:
Perspective building at the organisational level with regard to vision,
mission and values and at the level of trainers with a view to develop
leaders and alliances
To produce leaders and capacitate organisations for informed
leadership to lead people’s health movement
To develop alliances and networks for people’s causes
' ASIAN
CONSULTATION, 1999
23
Process
1. Critical analysis of existing conditions, programs, trends, relations
2. To develop combat strategies
3. To develop alternative paradigm
4. Internalising by the organisation
5. Participatory sensitization sessions
5. Creating conducive environment (need based)
6. Develop modalities for working with concerned people
6. Organisational effectiveness
7. Networking and sharing with other groups for further
development
8. Effectivenesss of communities to counter globalisation
9. How to channge donors' perspective, resource mobilisation internal and external
10. How to develop allies 1. Inter and intra country - activate existing ones and
make new ones
2. Critical study, exploration and policy making
3. Existing and emerging problems
4. Strategic partnership with people’s movements
5. Create alliances to make health a public agenda
Workshop I
Content of Training
The contents of the training on globalisation should include the causes
of the problems that affect the health of the poor, an indepth analysis
of the effects on poor people, measures to counter these effects and
alternative paradigms of development.
A Framework for contents of trainings:
To understand global problems, training should focus on
To understand its causes training is needed on
To understand the consequences, training is needed on
To understand the cost of not doing anything
24
ACHAN
To understand the mechanisms of how these causes result in such
consequences and how they are linked to health, training is 'needed on
Understanding what it will take to counter the effects of globalisation
and planning of alternative courses of action to effect needed internal
and external changes
The problem
Health care system
Lack of facility
Causes
Indigenous systems destroyed
No food security
Land alienation
Shift to cash crops
Failure of public distribution systems
Drought and degradation of the environment
High cost of medicines
Lack of government priorities
Budget cuts due to structural adjustment programs
Emphasis on urban areas
Effects
No health service to the poor
Untrained health personnel
Example
Outcome : Malnutrition
Immediate Outcome: Low food intake
Incidence of preventable diseases
A combination of both
These factors together form a viscious spiral. International donors
attacked the problem at this level and distributed food.
ASIAN
CONSULTATION, 1999
25
Underlying causes: 1. Decreasing household food security
• 2. Shifting from food crops to cash crops
3. Landlessness
4. Inadequate women and child care
5. Low access and utilization of health services shortage of essential drugs and poor
environmental sanitation
Intervention at this level is necessary but not sufficient
Intermediate cause: Lack of access to education especially for girls
Basic causes:
1. Poor have no control over resources
2. Inequalities in societies
3. Structural adjustment programs
4. Globalisation
5. Human rights violations
6. Oppressive political systems
7. Deteriorating terms of trade
8. Unemployment
For sustainable development, these issues have to be attacked.
Training Strategies
Discuss forms of a new modified training strategy
Convert existing training programs into training strategies
Engage in a sector analysis to identify resources and major issues
Set tentative objectives and desired outcomes for training
Critically evaluate your present trainings in the light of
globalisation
Ask how open is your constituency to this new training
Special needs of network NGOs, support NGOs and service
NGOs to carry out new training
- Strategies to face donors is needed - to start countering effects of
globalisation
26
ACHAN
Put training at the service of advocacy
Empower trainers to get involved in actions beyond mere
training
Seek links with existing national or local people’s movements
List resources - material, didactic, human, financial - needed for
new training
Share with colleagues the nature of the problems we are trying to
address - globalisation and its effects on health
Explicit training to be for whom to achieve
Convene a meeting with strategic allies and set priorities
Develop simple materials on globalisation and its effects
Seek funds for grassroots training on these issues.
Set criteria for / selection of participants
\ impact analysis of our actions
Identify other complementary strategies needed to achieve goals
of better health for the people
What a training strategy assessment entails:
1. What are training objectives?
2. What are components of training strategy?
3. What are training contents?
4. Have training materials been developed?
5. What training methodology has been chosen?
6. Who are the target groups?
7. What is the scale of your training operation?
8. Follow-up of training to study its impact?
9. Have the experiences been documented and shared?
Synthesis:
1. We recognise the current globalisation processes that directly and
selectively affect the lives of the poor
* the lack of adequate mechanisms to counter these processes
ASIAN
CONSULTATION, 1999
27
2.
Therefore, there is a necessity to play a proactive role in:
* NGO structures and NGO network structures through
appropriate training
* Enlarging the alliances and network among NGOs and
strategic partners outside
* Working and building upon people’s movements so that
health becomes a people’s movement
Strategy for Training
Training as a strategy
training as an activity
Contents: - trainers as doers
- trainers as decision makers
- how to secure a commitment to a new strategy on
global issues
- general guidelines for such a strategy
- Recommend if new structures will be needed internal
and outside
Workshop III
Training objectives, strategies and content for decision makers, mid
level workers and grassroots
Training for Decision Makers
Target: Decision-makers of the organizations/NGOs, managers and
directors
Selection criteria: involved in Health and Development (NGOs,
People’s organization)
Objectives:
To sentisitize decision makers on the effects of “G” on health.
To critically analyze their own organizations in the context of “G”
To enable them to respond to “G” with concrete actions.
28
ACIIAN
Contents:
Concept of Globalization:
-meaning
-players (WB, IMF, WTO, ABB)
-mechanisms
G in the context of the country
-health, economic, agricultural, social-policies
Impact of “G” on the life of the people
Impact of “G” on health
Content include tools for:
Analysis of the objectives, VMGSP and activities
Identification of gaps
Planning for changes
-info access
-networking/communication skills
-advocacy
Resource mobilization
Action plan
Methods:
Three phases: background materials
Lecture discusiion
Brainstorming
Comments:
• The feedback of the decision makers should be incorporated
• There is a need to incorporate case studies
• These training must have follow - ups.
Training for Middle Management
Objectives:
At the end of 6 days, the participants will be able to:
Internalize and articulate the underlying basic causes of malnutrition
in relation to “G”.
Describe various developmental approaches and models and
empowerement processes
ASIAN
CONSULTATION, 1999
29
Integrate in their respective programs and that projects this new
understanding about malnutrition and its causes.
Number of participants: maximum of 20
Training for the Grassroots
Target: Grassroots, the actors in the community
Criteria selection:
analytical capacity
committed to the cause
living in the community
can make decisions/influence
work towards implementation
preference: can read and write
Specific Objectives:
To develop a broader understanding on the causes and effects of ill
health and nutritional problems and issues.
Expectation and Commitment at the Country Level:
We are looking for partners who believe in what we believe in. The
partners in the country has the time, resources, space and will help
convene and work out the inputs from these workshops. They will
convene organizations in their country for action. This is a shared
objective.
Country Convenors/Facilitators:
India
Dr. Arole, CHAI, CINI
Bangladesh
GK
Indonesia
FKPKMI
Philippines
South - IPHC, North - IIRR
Sri Lanka
SARVODAYA
Planning at the Convenors Level:
• Have a consultation at the country level
• Convenors will convene partner NGOs or network and follow-up
this training
• Have an open line of communications - each organization can
have or develop their partners.
30
A CHAN
Synthesis
What is the cost of not doing anything?
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Increase IMR, morbidity to the levels of 1960’s
Increase malnutrition
Increase AIDS/TB/STDs
Increase number of orphans
Decrease utilization of facilities
Overloaded hospitals rejecting non-paying patients
Increase in self-medications, overuse of antibiotics
Food shortages, riots, looting
Street violence, gangs
Increase unemployement
Increase drug addiction
Further default in health care financing
Universalization of fee for service system with full costs
Increase donor funding, increase donor influence on health
policy
Increase dependency
Increase homelessness
Increase mental illness, suicide
Growing destitution of the elderly
Break-up family unit
Increase sex commerce, sex tourism
Increase pollution, environmental degradation
Increase fundamentalism
(j! -"10
Increase child labour
f , q- j->
/
And so on and so forth....
'
'
But we are not trying to make the people feel guilty. We are asking for
commitment for action. NGOs are not the ones who will make the
change for this - but the creation of the critical mass. We shall foster
unity with them and we want ourselves to be catalysts and validators
of these realities. We hope we can be active members or be part of the
movement who are the coalescing forces of change.
We started with Training and if this training will make the activist is
us, something some changes will surely come up.
ASIAN
CONSULTATION, 1999
31
ACHAN Advocacy Workshop
25-27 January 1999
Grande Ville Hotel, Bangkok, Thailand
Welcome Address
Prem John gave a warm welcome to the participants of this Advocacy
Consultation-Workshop. This is the last of a series of meetings
(previous to this were the ACHAN Strategic Partners Meeting and the
Asian Master Trainers' Meeting). He hoped that this will be another
productive session bringing in new and bright ideas.
Orientation to the Workshop
Edelina P. de la Paz
The objectives of the Advocacy - Workshop were presented to and
agreed upon by the participants. These are the following:
1.
2.
3.
4.
5.
Determine advocacy status of partner NGOs
Identify needs and gaps in advocacy work
Set-up a system of coordination among advocacy partners of
ACHAN
Develop advocacy agenda at country level and for ACHAN
Formulate program of action on advocacy.
Challenges in doing advocacy Work (Speech by Jaime GalvezTan, Moderator)
Dr. Jimmy Tan related his recent visit to Maripipi, Leyte in the
Philippines. This is where he had his post-internship rural health
practice in 1975. He found out that after more than two decades, the
place almost remained the same: no substantial change has happened
in this village. The roads are still narrow, bumpy and dusty. The health
center has only one volunteer health worker rendering health services.
He also visited a slum community in Pasay, where he is currently a
consultant of an Italian health project. The situation in Pasay has
worsened: more crowded housing and an increase in all kinds of
pollution (air, noise and water). There are still many community health
workers (CHWs) trying to help out. But though accessible, people do
32
ACHAN
not go to the government health centre because of the long queue, no
free medicines and the arrogant personnel.
These are realities which advocates must see in order to be effective as
advocates. We must be in constant touch with realities of those we
want to advocate for - the ordinary people.
According to him, the challenges that lie ahead for advocates, in
pursuing serious advocacy role are the following:
1.
Be constantly in touch with the poor. To effectively advocate,
one must experience life with the poor. This will lead to a better
understanding of their conditions and needs.
2.
Our attitude must be bold and daring. We must not remain
silent amidst the sufferings we see.
3.
Be aware of the changing milieu. There is increasing
democratization, devolution and decentralization that we should
take advantage of.
4.
Have a working knowledge of society. There are three major
social forces in society affecting change: State, civil society and
business. Each one of them interplay with one another. We must
be conscious of the dynamism of the three and put into good use
such dynamism for the good of the people we advocate for.
Based on the changing
milieu, advocacy for what and whom to target? Policy makers
should be greatly considered. As we forge solidarity with the
poor, we must inform them to know that others are speaking in
their behalf.
5.
Identify new audience in advocacy.
6.
Make use of existing technology. Look for short, quick and
effective means of communication to reach the poor. Be creative
and innovative. Use the language that is also being used by our
target.
7.
Link with the poor. For performing advocacy role, there is no
substitute to linking with the poor who actually feel the brunt of
the situation as they face all the sufferings.
ASIAN
CONSULTATION, 1999
33
Workshop I - Level of Advocacy Work
guide questions
1. Define advocacy
2. What is the status of advocacy work in the context of your country
situation?
- issues addressed
- target audience
- actions/activities
- organizational support
3. What are the problems/constraints that are involved in doing
advocacy work
Groupings:
Group I:
Group II:
Group III:
Shresta, Hariyato, Phoebe, Saulina, Prakash,
Suranjan
Shared, Bala, Arman, Sirimal, Apol, Dat
James, Hazel, Gaya, Sita, Vanh, Hang
Synthesis
Definitions of Advocacy
• There are three levels to advocacy:
1. advocates level - organise campaigns, sensitize groups, make a
case, mobilize resources, influence the government.
2. People’s level - empower the people, collective action, ensuring
continuity
3. Macro level - look at global forces.
• Avocacy is the process of taking a stand on an issue, mobilising
people and participate in the struggle to help the oppressed
A process by which those believing in the people’s cause, act in a
shared leadership to empower the people, to influence the State
and other policies on behalf of the people through combined
efforts of training, networking, information sharing and
sensitization.
•
34
A CHAN
Advocacy Status - Country Situation
Nepal
Issues - Human rights, development, globalisation, health policies,
ecology, rational drug use, women’s health, tobacco, alcohol, illicit
drugs.
Target - Policy makers midlevel decision makers, consumers,
politicians
Actions - seminars, talk programs, media, publication, alliance
building, demonstration
Philippines
Issues - Health, livlihood, education, governance, community
managed health care, essential drugs, AIDS
Target - community, people’s organisations, policy makers
Actions - Training, demonstration, publication, operation research,
seminars
Indonesia
Issues - health, religious harmony, socio-economic development
Actions - internal advocacy within the organisation, training, research,
publications, networking.
India
Issues - Ecology, women and child rights, panchayati raj,
globalisation, primary health care, AIDS,
Target - people’s organisation, trainers, networks, policy makers,
communities
Actions - research, training, publications and networking, rallies,
dialogue, NGOs
Sri Lanka
Issues - promotion of traditional medicine, globalisation, child rights,
rational drug use
Actions - Lobbying, campaigns, marches, training, pickets
Targets - Activists, communities
ASIAN
CONSULTATION, 1999
35
Vietnam
Issues - health care system, unregulated health practise
Actions - Training, education
Target - Teachers, community
Bangladesh
Issues - formulation of national health policies, reproductive health
rights, substance abuse, environmental concerns
Actions - Education, training, rallies, seminars, dialogue with policy
makers
Target - policy makers, communities
Sharing of Advocacy Experiences: International Baby Food
Action Network ( IBFAN )
Sita Letchmi
IBFAN works on the theme: "Think globally, act locally."
History of IBFAN:
1950’s-60s
Increase in the promotion of bottle-feeding, many
mothers are rejecting breastfeeding
1960s’-70s
Growing public concent, alarming Infant Mortality
Rates with 1.5 million deaths attributed to bottle-feeding
early 70’s
Public interest peaked, founding members(IBFAN)
were whistleblowers, all groups rallied in support.
Nestle sued the group because of the campaign title
“Baby Killers”
197?
Nestle boycott started, triggered a US Senate Cause
Inquiry by Senator Edward Kennedy
1979
WHO and UNICEF International Meeting on Infant and
Young Children Feeding, IBFAN was formed
1981
International Code of Marketing Breast-milk Substitutes
was adopted by the World Health Assembly
1984
Nestle boycott ended, Nestle publicly announced its
agreement to comply with the code
36
ACUAN
1985
IBFAN started series of Lactation Management Course
IBFAN published 1st edition of Health Workers Guide
to the Code which is now on its eighth edition
Coordinated monitoring, launched publications Feeding Fiasco, a report from Pakistan about Breaking
the Rules, State of the Code which showed companies
violating the Code.
1987
IFM formed - granted NGO status, regular meetings
with WHA
1988
Second Nestle boycott starts and remains
1999
Innocenti Declaration, by 1995 a National breastfeeding
Coordinator was assigned and established breastfeeding
committees
1991
WABA was formed to follow-up Innocenti Declaration,
Baby Friendly Hospital was initiated by WHO-UNICEF
1992
IBFAN/ICDC,
Regional
and
Annual
Code
Implementation training for government officials
1996
8th edition of Health Workers Guide with 740,000
copies printed in 71 languages
1998
IBFAN honored by RCA “Alternative Nobel Prize”, for
its untiring work on the issue and launched its new
publication - Guide for Manufacturers
Present
The struggle of 20 years is very much alive and requires
constant work and vigilance”
Open Forum
The many lessons we have to keep in mind are:
1. IBFAN has succeeded because of its staying power. The MNCs
and milk companies underestimated IBFAN’s strength. IBFAN
has been threatened, but did not yield. IBFAN is unrelenting. It
pushed through with networking and initiated militant activities.
2. The advantage IBFAN has is the emotional connotation which
was channeled into a militant political action.
ASIAN
CONSULTATION, 1999
37
With regards to the issue of globalization, the challenge for us is
to make the issue as emotional as possible. If the people will
really get angry, they will support the issue and channel their
anger to militant actions. Then, we can really pin down these
MNCs and those in power.
3.
Advocacy is political action. Advocacy should be seen in the context
of the country situation. It must be progressive and voice out people’s
concerns.
Sharing of Advocacy Experiences: Action for
Rational Drug Use in Asia (ARDA)
By Dr. Kumariah Balasubramaniam
ARDA is an Asian Branch of Health Action Intemational(HAI),
founded in 1981. All activists who went to support IBFAN stayed in
Geneva and formed HAL The ultimate goal of advocacy is to change
the world from A to B because there is no social justice in A. But the
people don’t know there’s A and you want to go to B. A large number
of those affected don’t know that they are affected.
In health, one great concern is the pharmaceutical issue. In 1970, in
Sri-Lanka, copies of national drug policies were given to various
political powers for comments. The Communist Party, which was then
in power, made some health policies:
limit the number of drugs
use of generic names
entire drug industry should be under the control of the government
•
•
•
The task was then given to the Ministry of Health and then to the
medical establishment which junked the policy saying that this is
detrimental to the health of the people. The government set up a drug
procurement system run by the Department of Trade. But now, big
businesses dictates the development of free enterprise. World bodies
such as UNCTAD, UNIDO, WHO, UNDP and UNIPEC formulated
pharmaceutical policies for the Third World. UN APED (Action
Program for Economic Development ) situated in Guyana set up
regional pharmaceutical centers all over the world.
In 1986. ARDA was formed and its first meeting in 1987 identified the
following tasks and priorities:
38
ACHAN
•
•
•
•
•
educate people about health
look at the prescribing practices of doctors, look at the
undergraduate curriculum of medical and pharmacy students
involve policy makers
do country case studies, e.g., diarrheal diseases, how mothers
view the problem, etc.
have health ministries meeting, also involve students and
especially the media in doing advocacy work
Workshop II: Problems, Constraints, Needs and
Gaps in Advocacy Work
Guide Questions:
Identify problems, constraints, needs and gaps in carrying out
advocacy role.
Synthesis
• Problems /Constraints in Doing Advocacy Work
• Lack of appropriate and timely information
• Rapid turnover of staff, no continuity
• Lack of solidarity and networks
• Beliefs and tradition (culture of silence)
• Advocacy not priority in organizations
• Non-conducive political environment (autocratic government)
• Lack of skills and creativity among advocates (political smartness,
politically naive)
• Fake NGOs, infiltration by industry implants
• Donor dominated agenda
• Marginalization of NGOs by government and policy makers
(WHO, UN Bodies)
• NGO dynamics (bureaucracy, non-transparency)
• Legal hurdles
• Strength of the opposition/ “enemies” are efficient
• Lack of human power, resources
• Capacity building/skills
ASIAN
CONSULTATION, 1999
39
1.
Needs
•
•
•
•
•
•
•
Accessibility (management information system)
Human Resource Management
Networking, solidarity building
Continuing conscientization/intemalization
Skills training
Developing screening criteria (on-going)
Developing alternative resources
Guide Questions
In the context of globalization.
• What are the priority issues that your organizations should be
addressing at the following levels:
a. Local
b. National
c. Pan-Asia
What concrete participation can your organization provide?
What do you expect from ACHAN?
•
•
Discussion of Advocacy Agenda - Edelena Dela Paz
1.
ISSUE:
The effects of “Globalization” on the poor people’s health, particularly
in Asia
• effects of the economic crisis on the implementation of PHC
• access to quality health care for the poor
• rising prices of health care
• decreased ability to pay
• privatization of health services
• inappropriate modem health technology
• transition to an alternative people-centered development paradigm
for health
40
ACHAN
1.
ACTIONS
a.
Local:
•
•
re-rision and re-mission of NGOs to support integration of
Globalization” into the existing programs bearing in mind the
basic orientation of the organizations
do action research
b.
National:
•
•
•
•
continuous advocacy work targeting policy makers, decision
makers, academe, general population and media
lobby work for national policy on alternative health system
have research info, management and training systems
national people’s forum.
c.
Pan-Asia
Strengthen network:
• regular and timely exchange of relevant information with ragard
to: health situation in each country and impact of “Globalization”
health policies other related data
• evolution of an alternative people-centered development
paradigm for health
• monitoring/documentation (India - CHAI, development of
indigenous knowledge)
• administrative and logistic support to each other
• sponsor regional people’s forum (VHSS)
• training support to ACHAN (SARVODAYA)
• continue building alliances
Our Pledge
We hereby pledge as individuals and organizations to
unrelentlessly study, expose and publicize the effects of Globalization
ASIAN
CONSULTATION, 1999
41
on the health of the poor of Asia, in order to actively bring about an
alternate concept and reality of a more equitable and people-controlled
system of health for all.
We make this pledge ourselves, to each other and to the peoples
of our countries in sincerity and the hope of a transformed society in
which every man, woman and child counts.
This pledge is based on our most basic values; and we are bound
spiritually to execute this pledge to the best of our abilities. May we
find strength in our unity of purpose and our deep belief in the power
of the human spirit.
42
ACHAN
Strategic Partners Meeting
19-21 January 1999
Grande Ville Hotel, Bangkok, Thailand
Directory of Participants
Bangladesh
A.B.M. Shamsul Huda
Director, Association of Development Agencies in Bangladesh (ADAB)
19/C Sheikh Saheb Bazar Road, Dhaka - 1205 BANGLADESH
Tel: 880-2-812353
Fax No. 880-2-8130395
e-mail: adab@bdonline.com
Nasir Uddin
Executive Director, Voluntary Health Services Society
Mailing Address: GPO Box 4170, Dhaka-1000 BANGLADESH
273 Baitul Aman Housing Society, Road No. 1 Adabor, Shyamoli, Dhaka
1207 BANGLADESH
Tel: (8802)812962, 815755, 817547
Fax. No.: (8802) 813253
e-mail: vhss@citechco.net ; nassir@citechco.net
Japan
Sato Hikaru
General Secretary, Asian Health Institute (AHI)
987-30 Minamiyama, Komenoki-cho
Nisshin-shi, Aichi 470-0111, JAPAN
Tel: 81-5617-3-1950
Fax.No. 81-5617-3-1990
e-mail: ahi@jca.ax.apa.org
India
Minaxi Shukla
Deputy Director, CHETNA( Centre for Health Education, Training &
Nutrition Awareness)
Lilavatiben Lalbhai’s Bungalow, Civil Camp Road, Shahibaug
Ahmedabad 380 004 Gujarat, INDIA
Tel: (079) 2866685,2866513
Fax.No. 28666513
e-mail: indu.capoor@lwahm.net
ASIAN
CONSULTATION, 1999
43
Ila Vakhra
Programme Officer. CHETNA
Lilavatiben Lalbhai's Bungalow, Civil Camp Road, Shahibaug
Ahmedabad 380 004 Gujarat, INDIA
Tel: (079) 2866695,2866513
Fax. No. 28666513
e-mail: indu.capoor@lwahm.net
F. Stephen
Director, SEARCH
219/26, 6th Main
Jayanagar IV Block, Bangalore
Tel: 9’1-80-6658303
’
Fax No. 91-80-6635361
e-mail: search@search.dabang.ernet.in
Rajanikant Arole
Director, Comprehensive Rural Health Project
P.O. Jamkhed Dist., Ahmednagar. INDIA
(91 2421 (21034), (21322), (21323)
Fax. No. 91 2421 21034
Debabar Banerji
Professor Emeritus, Jawaharlal Nehru University
Nucleus for Health Policies and Programmes
B-43 Panchshel Enclave, New Delhi 110017, INDIA
Tel: 91-11-6462851
Fr. James Culas
Director, Catholic Health Association India
P.B. No. 2126 Secunderabad.500003 A.P. INDIA
Tel: 91-40-7848457
Fax No.: 7811982
e-mail: chai@hdl.usninet.in
Hari John
Executive Trustee, ANITRA TRUST
S-6,32nd Cross, Besantnagar, Madras 600 090 INDIA
(91-44-8252702, 91-44-4919890
Tara John
Administrator and Training Coordinator, Women in Development Trust
DEENABANDUPURAM
(via) Vengalrajukuppam, Chittoor District, 517599
Andhra Pradesh INDIA
Tel: 91-4118-87233, 91-4118-872414
Fax. No.: 91-44-8270424
44
A CHAN
Rev. Dr. Jonathan H. Thumra
Program Coordinator. Development of Human Potential (DHP) Centre
Raphei Valley, Mantripukhri
Imphal - 795002, Manipur INDIA
Tel: 91-385-220320
J.P. Saulina Arnold
Executive Secretary, Tamilnadu Voluntary Health Association (TVHA)
18 Appadura Main Street, Ayanavaram, Chennai 600023 INDIA
Tel: 91-44-6450462
Fax. No. 91-44-619585
e-mail: tnvha@md2.vsnl.net.in
Indonesia
Sugiat Ahmad Sumadi
Chairman. FKPKMI/MPK MUHAMMADIYAH
JI Cempaka Putih Tengah XXII/39
Jakarta 10510 INDONESIA
Tel: 62-21-4202230
Fax. No. 62-21-4204433
Felix Honggo Gunawan
Executive Director / FK - PKMI
PERDHAKI PUSAT
JI Kramat VI/7 Jakarta 10430
Tel: (62-21) 3140455,3909245,39000602 Fax No. (62-21) 326044
e-mail: perdhaki@indo.net.id
Haryoto Sidik
Head of Education & Training of Health Manpower, MPK
MUHAMMADIYAH
JL Cempaka Putih Tengah IV/2 A, Jakarta INDONESIA
Tel: (62-21)420 44 33
Fax. No.: (62-21)420 44 33
Laos
Somphavanh Seukpanya
Program Manager, CHAMPA Project
P.O. Box 6284 Vientienne Lao PDR
(00856-21-313317
Fax No. 00856-21-314543
ASIAN
CONSULTATION, 1999
45
Nepal
Mana Rana
Chairperson, ADAG/Nepal
Anam Nagar, Kathmandu, NEPAL
Tel: 977-1-412153
e-mail: hrp@npl.healthnet.org
Shanta Lail Mulmi
Executive Director, Resource Center for Primary Health Care
P.O. Box 117, Kathmandu NEPAL, Baa Bazar, Kathmandu
Tel: 977-1-225675/243891
Fax No. 977-1-225675
e-mail: recphec@npl.healthnet.org
Mathura P. Shrestha
Professor/Chairman, Nepal Health Research Council
P.O. Box 7626, Kathmandu, NEPAL
Tel: (977-1)254220
Fax. No. (977-1) 37 1122
E-mail: nhrc@healthnet.org.np; mathura@healthnet.org.np
Philippines
Luz Divina S. Canave-Anung
Executive Director
Institute of Primary Health Care -Davao Medical School Foundation
P.O. Box 80712 Bajada. Davao City. PHILIPPINES
Tel: (63-82)226-23-44
Fax. No. (063-82) 221-35-27
e-mail: iphc@davao.fapenet.org
Demetrio F. Imperial Jr.
Regional Director for Asia, International Institute of Rural Reconstruction
(IIRR)
Y.C. James Yen Center, 4118 Silang, Cavite, PHILIPPINES
Tel: 63-46-414-2417
Fax No. 63-46-414-2420
e-mail: iirr@cav.pworld.net.ph
Sri Lanka
Telge Sirimal Wijitha Peiris
Chairman, Alternative Community Health Action
#37 Mulgampala Rd., Kandy, SRILANKA
Tel: 94-1 -646112
46
A CHAN
Dr. Vinya Shanthidas Ariyaratne
Health Advisor, SARVODAYA SHRAMADANA MOVEMENT
Damsak Mandira, 98 Rawatawatta Road, Moratuwa, SRI LANKA
Tel: 94-1-647159/645255/642669 Fax No. 94-1-646512/647084
e-mail: ssmplan@sri.lanka.net
Isidore Joel Fernando
Executive Member, ACHAN
45/1 Jawatte Road, Colombo 5, SRI LANKA
Tel: 94-1-502449/445375
Fax. No. 94-1-696632
Wanuweldura Sarath Perera Wickramaratne
Training Coordinator, PALTRA
240/1-1/1, High Leva! Road, Colombo 06, SRI LANKA
Tel: 94-74-515052
Fax. No. 94-74-514904
e-mail: paltra@lanka.gn.apcorg
Vietnam
Loo Tien Dat
Technician, The Pediatric Center
252/5 Ly Chinh Thang, F9 Q3 TP Ho Chi Minh VIETNAM
Tel: 84-8-8293962
Le Thi Yen Hang
Nurse, VN Plus
19/30 Craw Binh Trng Street
F5- Bins Thanh District, Ho Chi Minh City VIETNAM
Tel: 84-8-8940797
Fax No. 84-8-8940292
Claudio Schuftan
Freelance Consultant
PO Box 369
Hanoi, VIETNAM
Tel: 84-4-8260 780
Fax No.: 84-4-8260780
e-mail: aviva@netnam.org.vn
ASIAN
CONSULTATION, 1999
47
ACHAN Staff:
ACHAN Honorary Representative in THAILAND
Urairat Rujirek
Southeast Asia Office in Manila
P.O. Box 11 Central Post Office. Manila. PHILIPPINES
No. 9 Cabanatuan Road, Phil-Am Homes. Quezon City, PHILIPPINES
Tel: 63-2-5257105,63-2-9298805 Fax No.: 63-2-5249726, 63-2-9276760
e-mail: emc312@wtouch.net
Edelena P. de la Paz
Gerry P. Andamo
Violy V. Casiguran
Head Office in Madras
Post Bag 1404, Madras 600 105 INDIA
702 B Shivalaya 16C-IN-C Road, Madras 600 008 INDIA
Tel: 91-44-8231554
Fax No.: 91-44-8270424
e-mail: prem@md2.vsnl.net.in
Abigail Tauli
Ann David
Joseph Williams
Prem John
48
ACHAN
Asian Master Trainers Workshop
22-24 January, 1999
Grande Ville Hotel, Bangkok, Thailand
Directory of Participants
Bangladesh
Mohammed Golam Rasul Arman
Program Officer, Voluntary Health Services Society (VHSS)
272-274 Baitul Aman Housing Society, Adabor, Shyamoli. Dhaka - 1207
BANGLADESH
Tel: 880-2- 812962, 815755,817547
Fax No. 880-2-813253
e-mail: vhss@citechco.net
India
Suranjan Reddy BV
Dean of Training Programme, SEARCH
219/26, 6th Main Jayanagar IV Block, Bangalore, INDIA
Tel: 91-80-6658303
Fax No. 91-80-6635361
e-mail: search ©search.dabang.ernet. in
James Culas
Director, Catholic Health Association India (CHAI)
P.B. No. 2126 Secunderabad, 500 003 A.P. INDIA
Tel: 91-40-7848457
Fax No.: 7811982
e-mail: chai@hdl.vsnl.net.in
Prakash Vinjamuri
Medical Officer for Training, CHAI
P.B. No. 2126 Secunderabad, 500 003 A.P. INDIA
Tel 91-40-7848457
Fax No.: 7811982
e-mail: chai@hdl.vsnl.net.in
J. P. Saulina Arnold
Executive Secretary, Tamilnadu Voluntary Health Association (TNVHA)
18 Appadurai Main Street, Ayanavaram, Chennai 600023 INDIA
Tel: 91-44-645 0462
Fax. No. 91-44-619585
e-mail: tnvha@md2.vsnl.net.in
Tara John
Administrator and Training Coordinator
Women in Development Trust
Deenabandupuram
ASIAN
CONSULTATION, 1999
49
(Via) Vengalrajukuppam.
Chithoor District - 517 599 INDIA
Tel: 91-4118-87233
Indonesia
Haryoto Sidik
Head of Education & Training of Health Manpower, MPK
MUHAMMADIYAH
IL Cempaka Putih Tengah VI/2 A, Jakarta Pusat 10510, INDONESIA
Tel: (62-21)420 44 33
Fax. No.: (62-21)420 44 33
Sri Rahayu
FK - PKMI
JL Keramat VI No.7
Jakarta Pusat
Indonesia.
Felix Honggo Gunawan
Executive Director / FK - PKMI
PERDHAKI PUSAT
JI Kramat VI/7 Jakarta 10430
Tel: (62-21) 3140455,3909245,39000602 Fax No. (62-21) 326044
e-mail: perdhaki@indo.net.id
Laos
Somphavanh Seukpanya
Program Manager, CHAMPA Project
P.O.-’Box 6284 Vientienne Lao PDR
Tel:.0085,6-21-313317
Fax No. 00856-21-314543
" *• *
Nepal
■ Shared Onta
Program Coordinator, Resource Center for Primary Health Care
(RECPHEC)
P.O. Bo'x‘417, Kathmandu, NEPAL
•Tel: 977-1-225675
Fax No: 977-1-225675
-■e-mail: recphc@npl.healthnet.org
Mathura P. Shrestha
Professor/Chairman. Resource Center for Primary Health Care ( RECPHEC)
P.O. Box 117, Kathmandu, NEPAL
50
ACIIAN
Tel: (977-1)254220
Fax. No. (977-1) 37 1122
e-mail: nhrc@healthnet.org.np; mathura@healthnet.org.np
Philippines
Desiree Concepcion U. Garganian
Program Manager, Sexual and Reproductive Health Project
Health Action Information Network (HAIN)
#9 Cabanatuan Rd., Phil Am Homes, Quezon City 1104, PHILIPPINES
Tel: 632-929-8805
Fax No. 632-927-6760
e-mail: hain@phil.gn.apc.org
Florizel B. Tabayag
Training Development Staff, IPHC
P.O. Box 80712 Bajada, Davao City PHILIPPINES
Tel: (63-82) 226-23-44
Fax. No. (063-82) 221-35-27
e-mail: iphc@davao.fapenet.org ; iphc@weblinq.com
Sri Lanka
Telge Sirimal Wijitha Peiris
Chairman, Alternative Community Health Action
#37 Mulgampala Rd., Kandy, SRILANKA
Tel: 94-1 - 646112
Gaya M, Gamhewage
Director Community Health, SARVODAYA SHRAMADANA
MOVEMENT
98 Rawathawatte Road, Moratuwa SRI LANKA
(94-1 -647159/645255/642669
Fax No. 94-1 -646512/647084
e-mail: ssmplan@sri.lanka.net; sardana@lanka.ccom.Ik
Isidore Joel Fernando
Executive Member, ACHAN
45/1 Jawatte Road, Colombo 5, SRI LANKA
Tel: 94-1-502449/445375
Fax. No. 94-1-69663
Vietnem
Luu Tien Dat
Technician, The Pediatric Center
252/5 Ly Chinh Thang
F9 Q3 TP Ho Chi Minh VIETNAM
Tel: 84-8-829 3962
ASIAN
CONSULTATION, 1999
St
Le Thi Yen Hang
Nurse, VN Plus
19/30 Tran Binh Trong Street
P5- Binh Thanh District
Ho Chi Minh City VIETNAM
Tel: 84-S-894 0797
Fax No. 84-8-894 0797, 84-61-85 3299
e-mail: VNPlus@netnam.org.vn
Claudio Schuftan
Freelance Consultant
PO Box 369
Hanoi, VIETNAM
Tel: 84-4-8260 780
Fax No.: 84-4-8260780
e-mail: aviva@netnam.org.vn
ACHAN Staff
ACHAN Honorary Representative in Thailand
Urairat Rujirek
FAO, Phra Arthit Road, Bangkopk 10200 THAILAND
Tel: 66-2-629 2145
Fax No.: 66-2-629 2145
Southeast Asia Office in Manila
P.O. Box 11 Central Post Office, Manila PHILIPPINES
No. 9 Cabanatuan Road, Phil-Am Homes. Quezon City PHILIPPINES
Tel: 63-2-525 7105; 63-2-929 8805
Fax No.: 63-2-524 9726; 63-2-927 6760
e-mail: emc312@wtouch.net
Edelena P. de la Paz
Gerry P. Andamo
Violeta V. Casiguran
Head Ofice in Madras
Post Bag 1404, Madras 600 105 INDIA
702 B Shivalaya 16 C-IN-C Road, Madras 600 008 INDIA
Tel: 91-44-823 1554
Fax No.: 91-44-827 0424
E-mail: prem@md2.vsnl.net.in
Abigail Tauli
Ann David
Joseph Williams
Prem John
52
ACHAN
ACHAN Asian Advocacy Workshop
25 - 27 January 1999
Grande Ville Hotel, Bangkok, Thailand
Directory of Participants
Bangladesh
Mohammed Golam Rasul Arman
Program Officer, Voluntary Health Services Society (VHSS)
272-274 Baitul Aman Housing Society, Adabor, Shyamoli. Dhaka - 1207
BANGLADESH
Tel: 880-2- 812962, 815755,817547
Fax No. 880-2-813253
e-mail: vhss@citechco.net
India
Suranjan Reddy BV
Dean of Training Programme, SEARCH
219/26, 6th Main Jayanagar IV Block, Bangalore, INDIA
Tel: 91-80-6658303
Fax No. 91-80-6635361
e-mail: search ©search.dabang.ernet. in
James Culas
Director, Catholic Health Association India (CHAI)
P.B. No. 2126 Secunderabad, 500 003 A.P. INDIA
Tel: 91-40-7848457
Fax No.: 7811982
e-mail: chai@hdl.vsnl.net.in
Prakash Vinjamuri
Medical Officer for Training, CHAI
P.B. No. 2126 Secunderabad, 500 003 A.P. INDIA
Tel 91-40-7848457
Fax No.: 7811982
e-mail: chai@hdl.vsnl.net.in
J.P. Saulina Arnold
Executive Secretary, Tamilnadu Voluntary Health Association (TNVHA)
18 Appadurai Main Street, Ayanavaram, Chennai 600023 INDIA
Tel: 91-44-645 0462
Fax. No. 91-44-619585
e-mail: tnvha@md2.vsnl.net.in
ASIAN
CONSULTATION, 1999
53
Indonesia
Haryoto Sidik
Head of Education & Training of Health Manpower, MPK
MUHAMMADIYAH
JL Cempaka Putih Tengah VI/2 A, Jakarta Pusat 10510, INDONESIA
Tel: (62-21)420 44 33
Fax. No.: (62-21)420 44 33
Laos
Somphavanh Seukpanya
Program Manager, CHAMPA Project
P.O. Box 6284 Vientienne Lao PDR
Tel: 00856-21-313317
Fax No. 00856-21-314543
Malaysia
Kumariah Balasubramaniam
Pharmaceutical Adviser, Consumers International
P.O. Box 1045, 10830 Penang, Malaysia
Tel: 604-229-1396
Fax No. 604-228-6506
e-mail: ciroap@pc.jaring.my
Sita Letchmi
Project Officer, International Baby Food Action Network (IBFAN)
P.O. Box 19, 11700 Penang, Malaysia
Tel: 604-656-9799
Fax No. 604-657-7291
e-mail: ibfanpg@tm.net.my
Nepal
Sharad Onta
Program Coordinator, Resource Center for Primary Health Care
(RECPHEC)
P.O. Box 117, Kathmandu, NEPAL
Tel: 977-1-225675
Fax No: 977-1-225675
e-mail: recphc@npl.healthnet.org
Mathura P. Shrestha
Professor/Chairman, Resource Center for Primary Health Care ( RECPHEC)
P.O. Box 117, Kathmandu, NEPAL
Tel: (977-1)254220
Fax. No. (977-1) 37 1122
e-mail: nhrc@healthnet.org.np; mathura@healthnet.org.np
54
A CHAN
Philippines
Jaime Z. Galvez Tan
President, Health Futures Inc.
1086 Del Monte Ave., Quezon City 1105, PHILIPPINES
Tel: 632-374-3745
Fax No. 632-413-8669
e-mail: jzgt@skyinet.net
Desiree Concepcion U. Garganian
Program Manager, Sexual and Reproductive Health Project
Health Action Information Network (HAIN)
#9 Cabanatuan Rd., PhilAm Homes, Quezon City 1104, PHILIPPINES
Tel: 632-929-8805
Fax No. 632-927-6760
e-mail: hain@phil.gn.apc.org
Florizel B. Tabayag
Training Development Staff, IPHC
P.O. Box 80712 Bajada, Davao City PHILIPPINES
Tel: (63-82) 226-23-44
Fax. No. (063-82) 221-35-27
e-mail: iphc@davao.fapenet.org ; iphc@weblinq.com
Phoebe V. Maata
Specialist in Health, Regional Office for Asia,
International Institute of Rural Reconstruction (IIRR)
Biga 2, Silang, Cavite, PHILIPPINES
Tel: (63-46)414-2417 Fax No. (63-46) 414 2420
e-mail: iirr@cav.pworld.net.ph
Sri Lanka
Telge Sirimal Wijitha Peiris
Chairman, Alternative Community Health Action
#37 Mulgampala Rd., Kandy, SRILANKA
Tel: 94-1 -646112
Gaya M, Gamhewage
Director Community Health, SARVODAYA SHRAMADANA
MOVEMENT
98 Rawathawatte Road, Moratuwa SRI LANKA
(94-1-647159/645255/642669
Fax No. 94-1 -646512/647084
e-mail: ssmplan@sri.lanka.net; sardana@lanka.ccom.lk
ASIAN
CONSULTATION, 1999
55
Vietnem
Luu Tien Dat
Technician, The Pediatric Center
252/5 Ly Chinh Thang
F9 Q3 TP Ho Chi Minh VIETNAM
Tel: 84-8-829 3962
Le Thi Yen Hang
Nurse, VN Plus
19/30 Tran Binh Trong Street
P5- Binh Thanh District
Ho Chi Minh City VIETNAM
Tel: 84-8-894 0797
Fax No. 84-8-894 0797, 84-61-85 3299
e-mail: VNPlus@netnam.org.vn
Claudio Schuftan
Freelance Consultant
PO Box 369
Hanoi, VIETNAM
Tel: 84-4-8260 780
Fax No.: 84-4-8260780
e-mail: aviva@netnam.org.vn
ACHAN Staff
ACHAN Honorary Representative in Thailand
Urairat Rujirek
FAO, Phra Arthit Road, Bangkopk 10200 THAILAND
Tel: 66-2-629 2145
Fax No.: 66-2-629 2145
Southeast Asia Office in Manila
P.O. Box 11 Central Post Office, Manila PHILIPPINES
No. 9 Cabanatuan Road, Phil-Am Homes, Quezon City PHILIPPINES
Tel: 63-2-525 7105; 63-2-929 8805
Fax No.: 63-2-524 9726; 63-2-927 6760
e-mail: emc312@wtouch.net
Deien P. de la Paz
Gerry P. Andamo
Violeta V. Casiguran
56
ACHAN
Head Ofice in Madras
Post Bag 1404, Madras 600 105 INDIA
702 B Shivalaya 16 C-IN-C Road, Madras 600 008 INDIA
Tel: 91-44-823 1554
Fax No.: 91-44-827 0424
E-mail: prem@md2.vsnl.net.in
Abigail Tauli
Ann David
Joseph Williams
Prem John
ASIAN
CONSULTATION, 1999
57
Position: 1773 (3 views)