By Chijioke Kaduru
Football is politics as we wish it were: fair, fine, furious, just, and beautiful. We cheer our favourite teams because they play on a level playing field, in the broad daylight of history. They play for the whole world to watch, with the naked power and a visible audacity that have nowhere to hide, no secret to conceal, no treachery to harbour.
Politics, in itself, is however far from fair, fine, just or beautiful. It requires craft and cunning. It requires ruthlessness. And more often than not, it is murky water. What politics is, is at the core of why Medical Practitioners tend to steer clear of it, especially young doctors.
Medicine is about taking care of people in their most vulnerable states and making yourself somewhat vulnerable in the process. This is the fundamental element that guards the practice. And a few years ago I began my career as a doctor, with this fundamental element, at the core of my being.
When I began as a doctor, and even preceding that, when I began to study medicine, the majority of the concepts I have today, were absent from my store of ideals. Like everyone, I started my career, wanting to succeed. I wanted to care for the sick. I wanted to teach future physicians. I wanted to be a part of ground-breaking research into treatment modules for patients. I wanted to immortalise myself, as a care-giver, especially for children. I was, as we all are, a child of my environment.
Through my formative years as a medical student, and now as a young doctor, I traveled the world, and my travels provided me with an opportunity to see the world and explore the health and healthcare systems available around the globe. My work, with medical students and young doctors around the world, laid the foundation.
On this spring board, I moved home, to work in a hospital, as a budding young doctor. During this time, I came into close contact with poverty, illiteracy and sickness. I came into contact with the inability to treat a child because of lack of money. I came into contact with death, provoked by a lack of information on basic hygienic and nutritional practices. I came into contact with unwarranted and mitigable loss.
I began to realise at that time that there were things that were almost as important to me as becoming famous or making a significant contribution to medical science: I wanted to help those people.
But I continued to be, as we all continue to be always, a child of my environment, and I wanted to help those people with my own personal efforts. It took me months of learning and discovery, to come to terms with a simple unalterable fact: Isolated individual endeavour, for all its purity of ideals, is of no use, and the desire to sacrifice an entire lifetime to the noblest of ideals serves no purpose if one works alone, solitarily, fighting against social conditions which prevent progress.
Medicine, is nothing, if we ignore the effects of broad social policies on health and health care. Medicine fails, when we ignore the social determinants of illness and death. Medicine is limited beyond measure, when we ignore the relationships between work, reproduction, and the environment; or the impact of violence and trauma.
Illness is a disturbance of the individual, fostered by deprived social conditions. And no one understands illness, better than the physician. The physician recognises that the health of the population is an end in itself and social changes are needed that go far beyond the medical realm, to meet this end. The physician recognises that certain fundamental truths, connect Politics to Medicine.
Politics determines if citizens are employed, in turn determining living conditions and nutrition. Politics determines if our women are educated, with the well established relationships between illiteracy and illness. Politics determines if there is an access road between a pregnant woman’s home and the nearest health facility. Politics determines whether going to the hospital to seek care will push a family into poverty.
Politics determines the number of medical schools in a country and how well equipped they are. Politics determines the sanity of medical education and the ability of the medical schools to run smoothly and graduate doctors on time. Politics determines the number and location of well equipped healthcare facilities. Politics determines the number of health workers in public healthcare facilities. Politics determines the annual health budget and what it gets spent on. Politics determines whether the funds for health infrastructure are transparently spent or embezzled.
The idea that politics is integral to health, can therefore not be seen as a new idea.
Dr. Salvador Allende, former Chilean Health Minister and President, introduced the legislation that created the Chilean national health service, when he was an elected senator in the early 1950s. This was the first national program in the Americas that guaranteed universal access to services. The idea that Physicians need to make themselves central to the political process, is therefore not a new idea, either.
The new idea then, is that young physicians, must overcome the dark clout over politics, if they want to truly shape the health of their communities. Young Physicians must make themselves central to the political process, beyond health policy advocacy. Young Physicians must get involved, if we must achieve this dream that health becomes central to all policies.
The struggle for a better life, is even more difficult in the absence of good health. Health is integral to development. And Politics is integral to the propagation of health. All those ideals, all that need to help people, becomes futile, if we allow the conventional politicians free reign over the issues that affect health.
Politics has its intricacies and baggage. However, we must be bold and courageous in facing up to them, if truly we want to help people.
– Follow this writer on Twitter: @dr_kaduru