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'Health Democracy' Needed to Overcome Social Ills

by David Werner
THE United States, as the world's wealthiest nation, would appear to be making some big mistakes tn terms of meeting people's needs. In spite of the outbreak of peace . ft continues to spend 27% of the national budget directly on defence’ and 60% goes directly and Indirectly to military related expenditures'. The War Resisters League presents the following lethal statistics:
The US ranks first in military expenditures, military bases, military aid. naval fleets, combat aircraft, and nuclear warhead*, bombs, and testing — but fifth In literacy rates, sixth in GNP per capita, eighth in life expectancy, eighth In public health expenditures per capita. 16th in the percentage of women in university enrollment. 18th in infant mortality rate. 18th in economic aid as a percentage of GNP, and 18th In population per physician.
Add to this the results of a study conducted by a 37-mem-ber commission, including the former Surgeon General. C Everett Koop, and pollster George Gallup. The results, reported In the New York Times of 9 June 1990 under the heading Gloomy Report on Teenagers' Health , are as follows:
• Never before has one gen eration of American teenagers been less healthy, less cared for. or less prepared for life than their parents were at the same age.
• Hundreds of thousands of adolescents (suffer from) excessive drug use. unplanned pregnancies, sexually transmit ted diseases and social and emotional problems that can lead to academic failure or suicide.
• '...each year one million teen-age girls, almost I in 10. become pregnant, and 2.5 million adolescents contract a sexually transmitted disease.
• The suicide rate for teens ha* doubled »lnce 1968. and >0% of adolescent boys and 20% of girls have attempted »u Wide
• Violence Is a part ol many young people's dally lives... Every day 135.000 students bring guns to school, and homicide is the leading cause of death among 15-to- 19-year-oid blacks.'
• More than half of high school seniors become drunk (at least) once a month, and alcohol-related accidents are the leading cause of death among teenager*
• Thirty per cent of tenth graders have experimented with drugs (as compared to 5% in the 1950a). Half a millton 12-lo 17-year-okis have tried cocaine
The study concludes that. Many of America's young peo p'e. both rich and poor, from al! racial and ethnic back-grounds, have serious social, emotional and health problems. problems that have potentially disastrous consequences not only for the individual teen, but for society as a whole.'
The unhealthy and Inequitable health situation in the US is made even worse by the fact that the US Is the only Industrialised nation where health is still a privilege, not a right. The medical and health care business has become one of the country's biggest and most lucrative private Industries, with a powerful lobby, that relentlessly opposes a national health plan that would guarantee basic services to all.
Meanwhile. 37 million citizens lack any form of health insurance, one tn five children live in conditions of poverty.
and Bl^ks. Lagfgps and inner-city dwellers have child mortality rates double that of the national average. Washington D C has poorer child and mater nal mortality rates than Jamaica.
In spite of such Inequity, per capita spending on health is greater in the US than In any other country. But millions of poor people fall between the cracks. Health Is determined far more by social and political factors, by who has power over whom, than by health services per se.
As the Rockefeller study suggests. Improvement in levels of health turns on what some call the fairness factor', that Is. on the relative equality among all people In terms of distribution of resources, public services, decision making, and socio-poilHcal power.
In other words, the struggle for health is In essence a struggle for equal rights, equal opportunity and equal representation: that Is to say. for democracy.
If democracy is the precon dltlon for world health, then shouldn’t we all be celebrat Ing? Do not our newspapers and televisions inform us that we are on the threshold of a more democratic and healthy world? In country after country. we are told, tyrants have been overthrown and totalitarian’ states have ben routed by a free society of people* who now elect their own
Some pontiffs of world affairs even proclaim that history has come to an end : that the free market system' tuts triumphed over slate-con trolled economies! Democracy over repressive one-party government) In sort. CapitaUsm over Communism! Certainly. President Bush is celebrating the 'triumph of freedom and democracy . Recently he told a crowd at the Santa Ana Bowl — where he was introduced by freedom fighter Chuck Norris — that a new breeze has swept around the world, bringing new hope... Vaclav Have), free at last; Nelson Mandela, free al last; Nicaragua and Panama. free at last.'
The US government In recent years has stepped up Ils rhetoric about all the 'democratic' governments 1t has created, or tried to create. Ins Latin America, tn the Caribbean, In southern Africa in the Philippines, and in the Middle East.
But clearly, something is wrong with these 'democracies' that have been
so generously assisted and militarised by the US government and Its allies:
• Why is ll that our favoured Third World democracies have such wide and growing disparities in wealth. In health, and tn human rights between their different social classes?
• Why is corruption so rampant within these fledgling democracies'?
• How Is It that their fairly elected leaders manage to steal millions (or. "if they can. billions) from their national treasuries and fat development loans, and to stash their booty in the private accounts of collaborating foreign banks?
• And If these nations are truly democratic', why do they need lo use death squads and US-trained security police to target community health workers and to keep their people from organising and defending their basic rights?
Surely, something about our 'democratisatlon' of these puppet governments rings hollow. Something Is rotten In El Salvador. In Guatemala, In Honduras. In Chile, in Grenada, in Haiti, in Israel. In Indonesia, in Kenya, 1n Zaire, in the Philippines (yes, even under Aquino).
Something Is rotten In these and other countries where the US government has Intervened, often through dirty wars, assassinations, terrorism, covert operations and violation of International law, to set up Its so-called democracies .
Strictly speaking, of course, democracy means something rather different. It means 'rule by the people' or 'people power’. It means equitable self determination.
Ironically, the Third World nations where people have tried hardest to overthrow oppressive rule and to equitably meet everyone's basic needs are precisely those nations that the US has tried to destabilise and replace with Its puppet 'democracies' (which are often brutally undemocratic).
How does people's health tn countries that have won their liberation compare to that in such puppet democracies? Recalling the fairness factor, it Is no surprise that the status of health in Cuba is incomparably better than in El Salvador.
I am not saying that Cuba Is completely egalitarian or democratic. It is not. But with or without the facade of elections, Cuba is functionally far more democratic than El Salvador. Chronic hunger in Cuba is almost non-existent. Health care, education, housing and other basic needs are universally met. Persistent human rights violations in Cuba let us know that political freedom is incomplete. But the abuses tn Cuba are minimal compared to the death squads In El Salvador.
The new Nicaraguan gov ernment is the most recent tn ' the long list of US puppet democracies. After liberation, the Sandinistas, through gen uine people power, made spectacular gains in health and education. The February election was a triumph, not for democracy, but for low-Intensity conflict.
It Is still too early to know how Nicaragua's change of government will affect health. But. according to US guidelines, hospitals will be privatised and community health centres closed to make way for mandated 'economic adjustments'. As ever, the poor will suffer.
If Nicaragua remains a subservient pseudo-democracy, it may descend to the same abysmal levels of health and development that exist today In Guatemala. El Salvador. Grenada and other countries whose governments dance lo Washington's tune.
Clearly, this sort of 'democratisatlon' is a scam. It Is Important that we not confuse a free-market economy' with real freedom and democracy. For, as we have seen. Improvement In levels of health depends on real democratlsa-tion: that is. on the empowerment of groups of people, at the family, community and national level, so that everyone has a chance to participate as equals In the decisions that affect their well-being.
As we have seen, the health of the world and Its people is deteriorating. The current growth-oriented model of development has not caused health to 'trickle down' to the disadvantaged. Instead, the gap between rich and poor is growing, and cruel exploitation of both people and the environment has escalated.
Many will argue that an unbridled free market system Is not compatible with — and tends to suppress — genuinely
democratic. egalItarian social structures. Any system that al lows the strong lo benefit al the expense of the weak Is not conducive lo health for all. Third World Network Features.