The second day of Declaration 2017 opened with a thought-provoking session from various members of the People’s Health Movement Scotland, which forms part of a wider global movement of health activists, civil society organisations and academic institutions, working to promote health for all. The session, led by Neil Quinn of the University of Strathclyde’s International Public Policy Institute, raised and discussed the nuances of what we mean by the ‘right to health’, and focused on three key questions: What do we mean by the right to health? What are the threats and challenges to this right? And what solutions are there, and how do we campaign together to put these solutions in place?

Remco van de Pas, Research Fellow for Global Health and International Health Policies at the Institute of Tropical Medicine, spoke first of the need to uphold ‘the right to mental health in times of democratic regression’. Healthcare is, he said, a human right, and governments have a responsibility to provide care for all. However, health itself – both physical and mental – is reliant on the provision of many other basic needs: schooling, housing and social protection. This is of enormous importance to everyone, but especially to minority groups within society, such as asylum seekers and immigrants.

We find ourselves now, however, enduring a period in which many governments are failing to ensure the right to health by hindering adequate supply of these needs. Austerity measures, for example, are denying people housing, jobs and pensions, and the provision of care has often been downgraded to below human needs. Furthermore, a rise in nationalism across Europe and the world has created an attitude of insularity within individual states – each state must uphold its own citizens’ right to health, but this is almost impossible unless governments work in solidarity with one another, on a wider global basis. The right to health is further diminished by problems – such as famine – caused by climate change.

To overcome these issues, the People’s Health Movement must, van de Pas argued, campaign for governments to adopt and adhere to a sense of ‘shared responsibilities’ – an approach that isn’t yet linked with the general trend of global political impetus. ‘We lack,’ he said, ‘analysis and alliances’ and must ‘move out of our bubble’ if we are to ‘link localised campaigning with the bigger picture’. Only through doing so might governments adopt policies – across a range of issues – that lead to the protection of the universal right health.

At a UK level, Dr Anuj Kapilashrami, lecturer in Global Health Policy at the University of Edinburgh, explained how the UN recognition of the universal right to health (as enshrined in Article 12 of the 1966 International Covenant on Economic, Social and Cultural Rights) is being eroded by ‘systematic attacks on the National Health Service’.

A ‘shadow report into health’ illustrates how measures adopted by the UK government have led to a diminution in the provision of health care, and excluded ‘particular communities and the vulnerable’, as evidenced by limited maternity care for asylum seekers and those ‘forcefully detained on the grounds of mental health’.

People have, moreover, been ‘pushed into a cycle of further poverty’ by ‘deliberately retrogressive measures’, such as austerity policies, so that the UK can financially ‘live within its means’.

Such measures have resulted – as the third speaker, Dr Kat Smith of the Global Public Health Unit at the University of Edinburgh, explained – in a significant difference between the opportunities for health afforded to the rich and poor, particularly in Scotland which currently suffers ‘some of the worst health inequalities in the western world’.

Again, a problem has been that governments tend to focus on specific health issues – such as smoking or alcoholism – but do not attend to those other areas of life that impact just as much, if not more, upon individual health, such as housing, education and social protection, which can be considered to be the real sources of social and health inequality.

Dr Smith argued that to reduce health differences in the UK, more must be done to address these living and working conditions. To achieve this, a coalition, such as the People’s Health Movement, is required to campaign for these general, but essential, changes in much the same way that the tobacco-control lobby has campaigned for stronger legislation against smoking.

Next in the session, Bryan Simpson explained how the Better Than Zero campaign is helping people in precarious employment and on zero hour contracts who have found themselves working for the minimum wage and less. Better Than Zero advocates against the appalling exploitation of workers that still exists this country.

Similarly, representatives from the Glasgow Homelessness Network spoke of homelessness’ impact on the right to health and argued that health professionals should ‘listen and not assume they know what a person needs’. The assumption of some health professionals that the homeless person before them must have arrived at their situation from one of a small range of stereotypical factors, such as alcoholism, often leaves the homeless person feeling disempowered and ‘less than human’.

Finally, Dr Dina Sidhva, Associate of the Global Health Academy and Honorary Fellow of the Centre for South Asian Studies at the University of Edinburgh, spoke movingly about asylum seekers and refugees in Scotland who also live with HIV. Her photo-voice project documents the lives and experiences of people who often feel like ‘marginalised, stigmatised individuals’ engaged ‘in a journey that seems never-ending’.

This journey, although it is one that can at times ‘be positive and not only negative’, leads to a sense of ‘waiting… a sense of all-encompassing limbo… beyond our control… shaped by the omnipotent hand of immigration policies’ – policies that often remove from the individual their right to health.

This is a frustrating and traumatic experience for many. And a dangerous one. Several of Dr Sidhva’s participants declined to take part in her presentation, worried about disclosure issues that attest to a prevailing fear of being publicly identified and, as a consequence, being subjected to further prejudice.

This seems particularly tragic and heart-rending in light of one participant’s comment – quoted by Dr Sidhva – that, despite having taken flight from terrible circumstances elsewhere, ‘home is the familiar place all long to go back to… but we want a safe place here, to build a new life, and contribute to the community’.

Dr Sidhva’s talk was vividly illustrated by the Images from Limbo exhibition of photographs, which remained on display throughout the day in the entrance to Surgeons’ Hall. Taken to depict the lives and circumstances of asylum seekers and immigrants, the images served as reminders of Dr Sidhva’s descriptions of how immigration policies create a poverty that leads to an inadequate diet, which itself impacts on the sufferer’s ability to take HIV and AIDS medications, undermining a person’s right to health at a time when all they yearn for is ‘freedom and dignity’.

Encompassing a broad range of health professionals, activists and other organisations, the People’s Health Movement Scotland are committed to campaigning for legislative changes that, it is hoped, will lead to a more equal health system for all, and the protection of every individual’s right to health.

by Mark Jones

 

The People's Health Movement is a global network bringing together grassroots health activists, civil society organisations and academic institutions from around the world. Find out more about them here, and follow the People's Health Movement Scotland on Facebook and Twitter for upcoming events and ways to get involved.