Toward a Healthier World: Methods and Action for Change

To give some impetus to this last day of the People’s Health Assembly, the Planning Committee asked me to give a so-called “inspirational address.” I guess they want me to say something hopeful, something optimistic, that motivates all of us to keep slogging away in the up-hill struggle for the healthier, more compassionate world we all dream of.

But the Planning Committee caught me at a bad time or what looks like a bad time. Given the state of the world today, with its spiraling social, economic, environmental and moral crises, and with the trillion-armed, money-grubbing Deity that breeds these crises, what can I truthfully say that is optimistic? As we stand in the doorway of the new millennium, are we moving forward or backward? Currently, humanity’s hard-won progress toward a collective commitment to “well-being for all” has in many ways been reversed. Democratic process has been eroded. Billions of people especially women and children suffer deepening poverty, hunger, ill health, and unfulfilled lives.

Meanwhile the global economy, governed by profit-hungry corporations, grows at a cancerous rate, devouring nonrenewable resources, concentrating wealth into fewer and fatter hands, and unbalancing the planet’s life-sustaining systems.

Given the state of the world today what can I truthfully say that is optimistic?

Currently the world’s three biggest industries, dollar for dollar, are: 1) weapons, 2) illicit drugs, and 3) oil, in that order. Think about the far-reaching harm that these three huge industries cause to human and environmental health. Yet, together they control a pivotal chunk of the global economy and have a powerful political lobby. This makes attempts to regulate or control such industries for the common good extremely difficult.

Money not only talks, it buys votes. This helps explain why the dominant model of “economic development” in the world today is designed to further enriching the rich. Today dozens of the world’s biggest transnational corporations have a wealth exceeding that of many nations. While their chief executives earn millions of dollars a year, a forth of humanity barely survives on less than a dollar a day. The widening gap between rich and poor, both between countries and within them, is jeopardizing the health and reducing the quality of life of the growing millions of destitute peopleand ultimately, of us all.

The knowledge and resources to remedy these overarching problems exist. What is lacking is the olitical will. The world’s high-powered politicians, their palms greased by giant corporations, put their hunger for profits before human and environmental needs. The failure of national governments and of the United Nations to regulate the increasingly unbridled production of fossil fuels and toxic waste, endangers the ecological balance of the planet and in the long run the survival of all living things.

In sum, we human beings are riding a time-bomb of our own making. And more frightening still, most of us don’t even know it, thanks to the institutionalized disinformation of the mass media, As we bumble toward the brink of disaster, its Business as Usual.

But good grief! I was supposed to say something optimistic!

I have a confession. Sometimes I get discouraged. I, like many of you health promoters and activists here at this Assembly, have spent most of my adult life living and working in marginalized communities. On the positive side, I have taken part in initiatives where disadvantaged people, empowered through a process of “discovery-based learning,” have analyzed the causes of their hardships and ill health, and have taken action to improve their situation. I have wept with them at their losses, and have joined in celebrating their achievements. In this process, as in all community endeavors, we have had our high points and low points. And, for a number of years, we were indeed optimistic. The overall situation of disadvantaged people really seemed to be improving.

But, unfortunately, those times have changed. As we have heard through many testimonials at this Assembly, in recent years a lot of the earlier gains in people’s well-being are steadily being eroded. These reversals are harder to combat because they are not caused by local events that a single community or nation can come to grips with. Rather they have their roots in distant but overarching policies mandated by decision-makers at the transnational or global level. In the face of such sweeping yet inaccessible forces, local communities and their health workers too often feel disempowered.

Gains and Reversals of Health in Mexico: the Impact of NAFTA

On this note, I would like to share with you a bit of my own experience in Mexico. There is an old saying, “Poor Mexico, so far from God and so close to the United States.” For over 3 decades I have worked with poor farming families in Mexico’s western mountains range. As many of you have seen in your own countries, the history of community-based experiences in Mexico has been one of early advances followed by disheartening reversals. From the 1960s to the 1980s, the villagers' collective struggle for health led to measurable improvements. Under-fives child mortality dropped from one-in-three to about one-in-20. Far fewer children were malnourished. Fewer mothers died in childbirth. In many ways people’s quality of life improved, as did their self-confidence in their ability to change their world.

The history of community-based experiences in Mexico has been one of early advances followed by disheartening reversals.

Important to these achievements during those early years, the villager-run health program evolved through 3 phases:

  1. The first phase focused on Curative Care: the immediate felt need of mothers with sick and dying children.

  2. The second phase focused on Prevention. People observed that common maladies like diarrhea, worms, and scabies kept coming back again and again, so they took action to prevent them. Measures ranged from water systems and latrines to immunization and community gardens.

  3. The third phase focused on Sociopolitical Action. Village health workers helped people analyze the root causes of their health-related problems. They found such problems often arose from the ways in which the strong took advantage of the weak.

For example, a big cause of hunger and poor health had to do with land tenure and share cropping. These problems arose from the government’s failure to respect its own laws. After the Mexican Revolution of 1910, in which the peasantry fought for “land and liberty,” the new Constitution included potentially excellent agrarian reform laws intended to protect the rights of small farmers. However, due to institutionalized corruption, many wealthy ranchers kept title to their huge land holdings, which far exceeded the acreage legally permitted.

Hence many landless farmers became sharecroppers on rich people’s land. In exchange, they had to give the landlord half their harvest. Therefore, despite their hard work, they seldom had enough food for their hungry families. So they had to borrow back part of their own crop. For every sack of grain they borrowed at planting time, they had to return three sacks at harvest time. Trapped by this usurious loan system, poor families became further impoverished by escalating debt.

The villagers came to realize that the root causes of hunger and poor health are social and political.

To combat this deep-rooted exploitation, village health workers educated landless farmers about the Mexican Constitution. Demanding their constitutional rights, the peasants organized and began to invade the illegally large land holdings. As the peasant organization grew in numbers and strength, it successfully reclaimed over 50 percent of the illegally large holdings, which it divided among the poor.

The impact on health was impressive. If, in those days, you were to ask village mothers why fewer children died than in the past, they would tell you that the curative and preventive health services had helped a bit. They would insist, however, that the biggest reason for children’s better health was the people’s sociopolitical action. Redistributing land meant more food. More food meant better health. It was that simple.

The villagers had come to realize that the root causes of hunger and poor health are social and political. Although basic health services are essential, the overall health and quality of life of people in disadvantaged communities can only be improved through organized struggle for equal opportunities and equal rights.

During the late 1980s, despite growing hardships related to Mexico’s huge debt, the peasant organization continued to invade and redistribute the unconstitutionally large land holdings. And health indicators continued to improve.

But in the early 90s, things began to change for the worse. The global reach of the neoliberal market system created a whole new level of obstacles. Foremost of these was NAFTA, the North American Free Trade Agreement, implemented in 1994. In preparation for NAFTA, the United States government required Mexico to change its Constitution and annul its agrarian reform laws. This was done so that big American agribusiness could buy up huge parcels of Mexican farmland to grow vegetables at slave wages, for export.

Thus NAFTA put an abrupt end to the peasants' redistribution of the large land holdings. If poor farmers continued the land invasions, rather than being proud citizens defending their constitutional rights, now they would be common criminals and treated as such.

Both in rural and urban Mexico, NAFTA has had distressing results, for the poor but also for the shrinking middle-class. As farmland has reverted to giant neocolonial plantations, more than 2 million Mexican peasants have left the countryside for the mushrooming city slums. With this mass urban influx of hungry people competing for jobs, real wages have dropped by 40 percent in the last six years. Since NAFTA began, the population living below the poverty line has increased from 47 to 53 percent. The percentage of malnourished children has also risen and diseases of squalor, like cholera, have reappeared. The numbers of homeless people and street children have skyrocketed. And so have crime, violence, and drug trafficking …

NAFTA put an abrupt end to the peasants' redistribution of the large land holdings.

Meanwhile, the rich get richer. Despite the deepening deprivation of its growing underclass, today Mexico has more billionaires per capita than any other nation. The country’s extreme inequality has led to a rash of robbery and kidnaping, as impoverished young people with little hope for the future take an angry shortcut to redistribution of wealth. Their grandfathers fought a national revolution to achieve land and liberty, and won, at least for several decades. But now, much of what they fought for has been lost, thanks to the global economy. And the prospects of fighting the United States government and the global power structure seem far less hopeful. Kidnaping is a safer option.

For the people of a poor country to stand up against inequitable forces of today’s global economy, the odds are overpowering. It would be like David trying to fight Goliath, when David’s hands are tied behind his back and Goliath has nuclear arms. For this reason, to fight today’s Goliaths, we need international grassroots coalitions! The People’s Health Assembly is a ground-breaking step in this direction.

The reversals in social progress and the deteriorating health conditions seen in Mexico are similar to those in many countries today. Structural adjustment programs and unfair trade policies of the World Bank, International Monetary Fund (IMF), and World Trade Organization (WTO) have put corporate profits before environmental needs and human rights. By promoting the top-heavy economic growth they call “development,” world leaders are pushing us down a dangerously unhealthy and unsustainable path.

So is there any window for hope? Is it at all realistic for us at the People’s Health Assembly to be optimistic?

In a guarded way … I think the answer is YES. I like to believe that we are on the edge of a world-wide awakening. True, the process has barely begun. Still much of humanity is drugged by the consumer culture and duped by the mass media. And the world’s leaders are clearly asleep at the wheel! But the rumblings of the coming storm are beginning to shake more and more people awake.

From Racial to Economic Apartheid

When unfairness and inequality become insufferable, they goad the oppressed into demanding social justice. Look, for example, at South Africa. Two years before the fall of apartheid, I visited South Africa at the invitation of NAMDA, a radical association of progressive doctors and dentists. At that point in history the struggle seemed all but hopeless. Police violence was on the rise. Activists were being tortured and jailed, and community organizations crushed. It seemed that the harder people struggled for social justice, the worse things got. Activists had not given up hope completely, but they were deeply discouraged.

Before the fall of apartheid in South Africa the struggle seemed all but hopeless.

To look for a way forward, a big meeting of community health workers was held in Cape Town. The main speaker, who had just been released from jail, was a black activist nearly as popular as Nelson Mandela. In spite of the prevailing pessimism of the day, this remarkable man spoke with inspiring optimism. Noting the increasingly brutal measures of repression, he pointed out that such reactionary violence against popular organization was a sign that the ruling minority was fearful of losing control. The extreme brutality, he said, would prove counterproductive. Rather than stifle resistance, it united more people in protest. The speaker predicted that the apartheid regime, which seemed stronger and more immutable than ever, was in fact on the brink of collapse. He foresaw that a new government, elected by the disadvantaged majority, would soon take control. Needless to say, everyone at the meeting was energized by his speech. But few of us imagined that the sweeping change in South Africa would take place so soon.

Of course, contradictions remain. Racial apartheid in South Africa has now officially ended. But another sort of apartheid persists. Today the whole world lives under what might be called “economic apartheid,” with its arsenal of structural violence.

I am confident that the neocolonial inequity imposed by the global power structure can and will be overcome … by popular demand and international organized action. What is required is a critical level of awareness in a critical mass of people. The key to changing the world is mobilization from below, involving effective grass-roots networking and a spiraling process of awareness-raising—or, to use Paulo Freire’s term, “education of liberation.”

The importance of alternative avenues and methods of education in the process of realizing sociopolitical change cannot be overemphasized.

Today the most powerful weapon of the ruling class for social control is no longer brute force. It is not tear gas, stun guns, and rubber bullets. Rather it is institutionalized disinformation. It is the brain-washing power of the school system and the mass media.

Never underestimate the power of disinformation! To me, as a disillusioned Gringo, the recent presidential elections in the United States made the need for alternative avenues of education shockingly clear. There is an appalling lack of balanced information sharing and critical thinking. The multi-million dollar presidential campaign, financed by big business and trivialized by the mass media, made a mockery of democratic process.

Today the most powerful weapon of the ruling class is institutionalized disinformation.

Just look at who ran for office! The two top presidential candidates were George Bush and Al Gore, a hard-nosed Republican and a so-called Democrat, respectively. In a very weak third-place was Ralph Nader, representing the Green Party.

Bush and Gore had essentially the same corporate-friendly, political agendas, so they haggled absurdly over their petty differences.

The reason for the very similar campaign promises of Gore and Bush is that both unapologetically financed their campaigns with huge donations from wealthy corporations and conservative interest groups. In return for such legal bribery, both kissed the boots of their top funders. The campaign promises of both included massive military spending, further welfare “reforms” depriving the needy, zero tolerance for crime, approval of the death penalty, costly privatized medical insurance with inadequate coverage for the needy, further liberalization of trade, and celebration of the United States as global policeman.

In striking contrast to Gore and Bush, the Green Party candidate, Ralph Nader proposed policies that were consistently pro-people and pro-environment. These included a radical decrease in military spending, higher taxes for the rich to provide increased public assistance and universal health care, fair trade not free trade, an increased minimal wage to lift lower-income workers out of poverty, a moratorium on the death penalty, and an end to the embargos on Cuba and Iraq. In keeping with his call for stronger participatory democracy, Nader’s campaign both refused and avidly opposed corporate donations.

All in all, Ralph Nader’s platform was much fairer and in keeping with the needs of every-day working people than were those of the corporate puppets. Rather than harping on trivial differences, he clearly discussed issues of profound importance to the well-being of ordinary people and the planet.

Why then did Ralph Nader only get 3 percent of the vote? And why couldn’t more people see he is more committed to their interests than are his money-grubbing rivals?

The answer lies in the system of campaign financing, which translates as one-dollar one-vote; and in the brain-washing power of the mass media which happen to be owned by the same profit-hungry corporations that financed Bush and Gore’s campaigns.

Tragically, this sort of brainwashing of citizens' minds to win elections is not unique to the United States. It happens in the Third World, too. In Mexico, for example, in this year’s presidential elections the two parties that favor NAFTA and the economic growth of the ruling class, ran neck to neck. By contrast, the candidate who best represented the interests of working people and the poor majority (like “Ralph Nader in the US) got only a small fraction of the votes.

The fact that so many people in the United States, Mexico, and much of the world can be so pervasively misled by the elitist powers makes the need for alternative methods of information-sharing painfully apparent. This is why the fostering of “Education of Liberation” is so basic.

If it is true that"Disinformation rules the world,” it follows as certainly as day follows night, or as the Phoenix rises from her ashes that “The truth shall set us free.” For truly, knowledge is power, especially when enough people are well-informed, and when they learn through their own observations and critical analysis to separate the pearls from swine. I would suggest that one of the big challenges for those of us here at the People’s Health Assembly is to effectively develop and disseminate alternative avenues of information-sharing, that is, a liberating approach to education. By this I mean a learning approach that is awareness-raising and empowering, a problem-solving process that helps people make their own observations and draw their own conclusions. It will need to include a thoughtful, critical view of the mass media so that people can recognize disinformation for what it is.

Fortunately, a lot of community-based programs represented at this Assembly have already developed skills for facilitating this sort of liberating learning process. Such discovery-based learning methods include everything from participatory forms of community diagnosis and group problem solving to story telling, role plays, interactive theater and puppet shows, as well as consciousness-raising comic books and photo-novels.

But while these “learning methods for change” have worked well in the past, it is urgent that we adapt them to the new problematics of the 21st Century. To mobilize people to understand and confront the debilitating aspects of globalization, we need methods and materials that can help them recognize the links between macro and micro events. For example, through “chains of causes” and “But why?” games, people can visualize ways in which policies and decisions at the global level translate into personal hardships and health problems in their daily lives.

Many stories and testimonials presented at this forum have dramatically made such links between macro and micro causes and events. Our next step must be to share them as illustrated documents and post them through the Internet. Especially important to this exchange are experiences showing how different peoples are working together to cope with or oppose the negative effects of globalization. Such a grassroots exchange can help build bridges of understanding and world-wide solidarity needed to unite a critical mass of well-informed, sociopolitically conscious people.

Around the world today there are literally hundreds of networks working for structural change. But there is need for greater interdisciplinary linkages.

Remember: community-based health programs and health workers around the world have played a critical role in liberating their people from oppressive powers.

Some activists devoted to alternative economics, the environment, or human rights and other fields make little effort to include the health sector, and some are downright suspicious of it. This is partly because, when they think of the health sector, they think of the mainstream Medical Establishment with its conservative doctors and pharmaceutical companies who profit shamelessly from poor people’s ill health. Unfortunately, they have a point.

However, those of us here at the PHA know that there is another, far more progressive side to the health sector or public health sector a bit like the “theology of liberation” within the conservative church.

Historically, in the perennial struggle for change, it is important to remember that community-based health programs and health workers around the world have played a critical role in liberating their people from oppressive powers. There are many inspiring examples.

  • In Nicaragua under the dictatorship of Somoza, community health workers helped to organize people to defend their health and rights. Such community organization was branded as subversive and many health workers known as “brigadistas de salud"were targeted by death squads. A lot of brigadistas went underground and became leaders in the Sandinista resistance. After the overthrow of Somoza, these brigadistas played a key role in designing the new health ministry. With the help of strong community involvement, extraordinary improvements in health were achievedif temporarily.

  • Similarly in El Salvador and Guatemala community health promoters played a central role in the struggle to replace tyrannical regimes with somewhat more representative governments.

  • In the Philippines a national network of Community Based Health Programs helped to educate and mobilize the population in what led to the massive peaceful uprising that overthrew the dictator Ferdinand Marcos.

  • Likewise, the popular health movement in South Africa played an important part in the struggle to overthrow apartheid.

While we are talking about struggles for health and liberation, we must not forget Gonashasthaya Kendra, where we are gathered together here in Bangladesh (See Newsletters #44 and #70). As I am sure all of you are aware, G. K. was born out of the struggle to defend the health and rights of vulnerable people during the war for liberation. Of course, after the war, the struggle for liberation from unfair laws and an unhealthy class system continues. A great deal has been achieved, but sometimes with high human costs.

Several years ago one of G. K.’s outstanding health workers was assassinated by thugs for defending poor people’s water rights against a cruel landholder. In the health worker’s memory, Zafrullah Chowdhury wrote the following insightful declaration:

> Primary health care is generally only lacking when other rights are also being denied. Usually it is only lacking where the greed of some goes unchecked and unrecognized (or unacknowledged) as being the cause. Once primary health care is accepted as a human right, then the primary health worker becomes, first and foremost, a political figure, involved in the life of the community and its integrity. With a sensitivity to the villagers and the community as a whole, he will be better able to diagnose and prescribe. Basically, though, he will bring about the health that is the birthright of the community by facing the more comprehensive political problems of oppression and injustice, ignorance, apathy, and misguided goodwill.

In all of the above-mentioned countries—Mexico, Nicaragua, El Salvador, Guatemala, the Philippines, South Africa, and Bangladesh—organized efforts at the community level helped to achieve significant improvements in health. Unfortunately, in recent years, each of these countries has experienced stagnation of their health gains and deterioration in their standard of living. These reversals are largely rooted in the global power structure. In those countries where popular uprisings had replaced repressive regimes with governments that put human needs before corporate profits, the U.S. government forcefully intervened. It used everything from illegal embargos to mercenary “counter-revolutionaries” to destabilize those pro-people states and prove to the world that suchpopular governments were not viable alternatives. In the last decade or so, these progressive governments have had to compromise their egalitarian ideals in order to survive within the global economy. Contributing to their setbacks have been their escalating debt burden and structural adjustment policies, as well as trade accords that weaken their self-reliance, deplete their resources, and undermine their national sovereignty.

In view of these pernicious aspects of globalization, we can understand why the International People’s Health Council (IPHC) declares that “The struggle for health is the struggle for liberation from poverty, exploitation, and unfair social-economic structures."

Coalition Building: International, Multi-Sectoral, and Across Classes

The overall level of health in a community or nation or in the world as a whole is a good indicator of its degree of equity and social justice. For this reason, health can be a good entry point in the struggle for fairer, more sustainable alternatives.

I would like to emphasize again that one of the key elements in creating a healthier world comes down to the healing of old wounds and the building of bridges. The Achilles heel of the Left and of progressive social movements in general has been infighting and division within the ranks. The social vision of the Left, in a nut-shell, is to construct a society based on equal opportunities and human dignity for all. If we are to revive that vision, we must learn to respect our differences and embrace what we have in common.

To successfully confront and transform the elitist global order, it is essential to reach across national boundaries to build international coalitions. Equally essential is to build cross-sectoral solidarity. To this end, one of the strategic goals of the People’s Health Assembly has been to bring together activists and progressives, not just from the health sector, but from all the various sectors that affect health that is, from virtually every sector.

The Achilles heel of the Left and of progressive social movements in general has been infighting and division within the ranks.

This PHA event in Bangladesh is a big step forward toward building multi-sectoral solidarity. But we still have a long way to go. In the follow-up activities of the PHA, it is essential for us to build a pragmatic coalition among progressives in the three key sectors of Health, Environment, and Economics. New, more balanced and sustainable alternatives that bridge these three sectors are essential to achieving a healthy way forward.

Also important to coalition building is reaching across class barriers, at least where this is possible without sacrificing integrity. We need to include concerned persons and groups from every level of the social spectrum. True, the “voiceless poor” must have a much stronger say in the decisions and policies that affect their lives. But it is also important to reach out to those in the middle and upper classes who are becoming increasingly worried about the unconscionable inequities of the dominant social order.

Some of the world’s wealthiest financial wizards and top economists—ranging from billionaire George Soros to Herman Daly, Davison Budhoo and Joseph Stiglitz, all former high-ranking economists of the World Bank or IMF—have begun to question the prevailing economic ideology based on “growth at all costs.” They, too, are looking for fairer, more sustainable alternatives.

In spite of the roll-back of social progress and the claim that, with the globalization of corporate rule, “history has come to an end,” we may in fact be on the doorstep of a new age of enlightenment. Little by little, more and more people are beginning to realize that all life is interconnected. The health of each of us depends upon the health of all of us and upon the health of the planet that we are guests upon.

Before I close, I would like to stress again the importance of fostering alternative forms of education and communication, which are the key to popular mobilization for change.

The ‘Battle in Seattle’

I am sure everyone here is aware of the so-called “Battle in Seattle,” at the end of 1999. This massive multi-sectoral protest against the World Trade Organization was a major breakthrough in terms of social awakening about the harmful human and environmental effects of globalization. Over 10,000 people from more than 60 countries participated. And as the wave of awareness spreads, Seattle has been followed by similar protests against the World Bank and IMF in Washington D.C., Sidney and Prague.

All of these protests represent an outpouring of participatory democracy within a political power structure where the electoral process has been trivialized by big money. Far from being mindless rabble rousing, as claimed by the mass media, these protests have been strategically planned, with a well-organized educational focus. There have been public lectures, discussion groups, and participatory theater, all with well-documented sociopolitical analysis. In short, these massive rallies have had a strong component of popular education for change.

Before the ‘Battle in Seattle,’ few people had ever heard of the World Trade Organization.

Also, the protests have helped bring together for the common good different groups that have often been antagonistic. At Seattle, this was symbolized by the rallying cry, “Teamsters and Turtles,” representing the newly united front comprising both labor unions and environmentalists.

Before the “Battle in Seattle,” few people had ever heard of the World Trade Organization. But now, around the world, awareness is growing about the socially regressive and ecologically distressing aspects of globalization. Such proliferation of critical information and collective analysis is a strong first step in organized action for change.

The Zapatista Uprising and the Web

In terms of alternatives for sharing information, we must not forget the Internet. Like fire or water, the Net can be both friend and enemy. On the one hand, it has expedited the global reach of transnational corporations. On the other hand, it has become an invaluable tool for the building of worldwide coalitions of activists and progressive movements.

One of the most exciting uses of the Web in grassroots struggles has been in the Zapatista uprising, in southern Mexico. On the day that NAFTA officially began (January 1 1994), the marginalized tribal people in the state of Chiapas declared their revolt. It was a protest against the betrayal of Mexico’s land reform program and the government’s sellout to the international market system. Although the mini-revolution consisted of only a handful of hungry Indian peasants, they broadcasted their demands for human rights and equal opportunities so effectively through the Internet, that progressives around the world responded vigorously.

Had it not been for this international solidarity, the Mexican army would have brutally squashed the Zapatistas from the start. But as it turned out, the international outcry was so great that the Mexican government had to capitulate to at least some of the Zapatistas' demands, by reinstituting part of the agrarian reform policies it had annulled in preparation for NAFTA.

The Zapatista uprising with its international solidarity has had a far-reaching ripple effect, which continues to this day. This year (2000) in Mexico’s presidential election, the people at last threw out the corrupt, elitist political party (the PRI) that had ruled the country for 7 decades. This end to one-party rule can in large part be explained by the political education spearheaded by the Zapatistas, through the Internet and alternative press.

We must remember, however, that the Internet still is accessible only to the more affluent 0.5 percent of the world’s population. If the poor majority are to take part in building a healthier world, we must be very creative in looking for ways to share information with them and to meet them on their terms.


The overarching goal of the People’s Health Assembly is, quite literally, to change the world. Our vision is to help create a world that is a fairer, heathier place for all people.

Albert Einstein, who realized all things are relative, also shared this vision. He said:

“Not until the creation and maintenance of decent conditions of life for all people are recog-nized and accepted as a common obligation of all people and all countries—not until then shall we, with a certain degree of justification, be able to speak of mankind as civilized.”

I would like to add one last, rather personal thought. It is about what keeps me going when I get discouraged.

I like all of you here, I assume am committed to struggle against injustices at the macro level. But the globalized power structure is so huge, and seems so impervious, that sometimes it gets me down. I feel a bit like Don Quixote fighting the windmill!

What lifts me back up is my personal involvement at the micro-level. When I am not grappling with the global Colossus, I am still active in the community-based program in Mexico, where disabled villagers help to enable handicapped children and their families. My greatest satisfaction comes when, with my companions, I am able to make a small but significant difference in the life of a child or family. While this is certainly not a transformation on the global scale, it is none the less uplifting. And somehow I think it contributes to the larger change.

There are many ways, large and small, that each of us can help make the world a better place. Each time one of us reaches out to a friend or stranger in need, each time we comfort someone who is sorrowing, each time we embrace a lonely child with love, or nurture someone who hungers for understanding, each time we defend the dignity and rights of an outcast whether innocent or guilty whom the righteous throw stones at, each time we give of ourselves with open arms and with joy, we add a grain of sand to the building of civilization to which our budding humanity … and all humanity … aspire.

For me, it is being personally involved at the village level it is seeing how the lives of caring people whom I have grown to love are afflicted by social injustice on a global scale that tells me that I must not lose heart in the struggle for a healthier world order.

In sum, I would suggest that all of us try to keep a balance in our quest for change at the macro and micro levels. It is the mini-transformations that happen on a personal level, in solidarity with friends, that will guide our efforts to transform the world. It is our local involvement that keeps our global activism on target.

I am confident that the day will come when the world’s people will become one grand and diverse community, gladly sharing our human and material resources with one another, for the good of all. I see the ongoing activities of the People’s Health Assembly as the standard bearer and catalyst in this transformative process.

Publication Information


Address by David Werner for the People’s Health Assembly Savar, Bangladesh, December 4-8, 2000.