While reading for our next class, these questions came in my
mind: Can our practices to help people
increase their sufferings? Can our good intentions bring harm rather than good?
Can our interventions be structural violence practices?
Dealing with health problems in the developing world is a
critical issue especially when dealing with sensitive issues such as HIV/AIDS.
Public health planners, service delivery personnel and NGOs policy makers used
to deal with such problems from a single perspective. They usually blame the
individuals for their practices and consider them as being guilty rather than
victims. They neglect how world is changing in the era of globalization and how
the neoliberal ideologies put these populations under continuous pressure to
gain their normal rights of just keeping alive through the extreme harsh economic,
political and social challenges that they face. They tend to follow the up-down
approach in dealing with health issues for these suffering populations that is
focused on practices targeting individual behavior change and then got
surprised why they are not effective as they are in western world. People in
western world have the ACTUAL choice to change their behaviors to be healthy.
However; in the developing world, people tend to have the choice THEORITICALLY
but not practically. I remember the story of the Haitian girl “Acephie” who
lost her life from AIDS that we read about a couple of weeks ago. Are we brave
enough to blame her for her behavior and consider her to be guilty?! Did she
really have the choice?!
The strategies of tackling health issues among those on the
bottom of the socio economic gradient should be reformed. Taking structural barriers
and inequalities in consideration is a must if we really need to help. Empowerment
of the community and using the bottom-up approach is an urge. Culture is not
usually impeding. If we understand it and its associated conditions well and
pay attention to the voice of those whom we are planning to change their lives,
culture can be turned into a facilitating factor in order to avoid wrong, ineffective
and structural violent interventions.
Salma, I completely agree with you. A bottom-up approach is needed. I do not blame Acephie or many others suffering in structural violence for their actions. You are right, they do theoretically have a choice, but practically? No way. Working in a food pantry has taught me a lot of patience and understanding: you can’t blame someone for poor eating habits if they are starving, can’t afford food, and the only food that is presented to them is of poor quality. If I were hungry and poor and had a husband or kids or family to provide for, I would take whatever I could get. What does the world expect, what do NGOs expect? For these individuals to not accept this food and spend more than they should on healthier options? Really? That is very unrealistic. A structural change to society, locally and globally, needs to be met. I am happy we see eye to eye on this important topic. Keep the passion Salma. People like you will change the world!
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