Updates on Donde No Hay Doctor—Revision and Translations
The Spanish edition of Donde No Hay Doctor (my villagers' medical and health care handbook) has a number of shortcomings of which I am becoming increasingly aware. A revision is needed and will be undertaken as soon as time and resources are available. Nevertheless, the book has been enthusiastically received throughout Latin America, especially by villagers themselves. In Costa Rica it is distributed to all the rural nurse-auxiliaries working for the Health Ministry, and in Colombia it has been translated into Guajivo, the main Indian language of the Llanos.
An experimental edition of the modified English version, Where There Is No Doctor, is almost ready, and should appear in the Spring of 1977. Hopefully, it will fill a need in Anglophonic parts of Africa and Asia, as well as provide the prototype for translation into other languages; interest has been expressed for Portuguese, French, Hindi, Urdu, Swahili, and Indonesian.
The Future of Hesperian: Manuals Promoting Informed, Mutual Self-Care
My recent trip to England confirmed our observation that throughout Latin America and the developing world, there is a conspicuous lack, as well as great need, for simple (but not childish) self-help manuals in fields relating directly or indirectly to health. Now that my frequent absence from the ongoing program in México has become more necessary than my presence, I feel that one of the most important roles I can fill in rural health care is to participate in the creation of this sort of self-help manual.
Already, with potential collaborators in Guatemala, Honduras, Costa Rica, Colombia and England, we have begun a dialog for the preparation of self-help manuals in the fields of village dentistry, veterinary care and animal husbandry, agricultural extension appropriate village architecture, midwifery and home rehabilitation/physiotherapy. The proposed manuals will be geared to the assumption that people with little formal education have the native intelligence and potential will to meet most of their basic needs for and themselves. They will do so if given half a chance, and if provided clear precise information in the idiom they best understand.
Now that my absence from the Piaxtla Project has become more necessary than my presence, I feel that one of the most important roles I can fill in rural health care is to create of self-help manuals.
The development of these self-help manuals will be a practical and tangible step in our growing campaign for informed, mutual self care as a viable alternative to the present dehumanizing onslaught of institutionalized health care delivery. To be most effective, primary health care should not be delivered, but encouraged. It should largely be a question of education, and fostering informed personal concern. Yet as governments of the world have increasingly come to accept the doctrine of the World Health Organization, that access to health care should be considered a basic human right, a mass, politically-loaded movement has sprung up to try to deliver pre-packaged stereotyped health care services to all. The result has been to expropriate both the responsibility and practicability of health care from the people themselves and to make them increasingly dependent on the central power structure.
I suppose one must agree that access to health care should be considered a basic human right. Yet when health care is turned into a formula or system imposed upon the oppressed by outside benefactor-oppressors, this “human right” can become a humiliating and disabling wrong. I would prefer to be a spokesman for what I am coming to see as the most fundamental, and certainly the most easily alienable, of human rights: the right of the, people – as individuals, as families and as communities – to stand on their own feet, to make their own decisions, and to care for themselves.
Nowhere has this basic right been so systematically and purposefully denied than in the sectors which bear those political euphemisms——Health and Welfare. The implications of this have been discussed to some extent in the paper, Health Care and Human Dignity, and I hope to explore them more fully in the expanded version of this paper as well as in future newsletters.