Guiding health professionals to a career of political engagement is (better late than never) an absolute necessity for social change and social justice in health care.

Ponder: universities clearly favor ‘preparing career-ready graduates’ so that curricula, in our case, staunchly avoid critical pedagogies that promote a justice-enhancing health professional praxis; politicizing their curricula, their pedagogies, and the (social) engagement of their students is far removed from their aims.

The call I, therefore, make here is to help these professionals wake up so as to, in their professional lives, become contributors to setting up policies that truly benefit the mass of their patients and the communities they live in. It is about them having the tools in their hands to create a better future instead of limiting themselves to standing by and just observing the relentless flux of what is happening outside their strictly clinical practice.

This points us to the role of the curricula of these professionals. Do they equip students with the power of knowing all about the uneven power relations at play in the health sector? This knowledge does clearly not come automatically. Students cannot really find the relevant facts about this in medical libraries. These libraries are the depositories of mostly biomedical science and clinical studies but do not provide help to health professionals in engaging in the fight against the exertion of unjustified power in what is a pyramidal health power structure. (The internet these days may be a complementary depository, but students will have to know where to go—and the curriculum ought to point them in a good direction on this, avoiding bogus information).

Learning about the power structure is where learning about human rights starts, precisely because power disregards equality in the access to health care, and this is determined by the primacy of financial considerations and by the force of authority exerted vertically—this illegitimate authority most often being dehumanizing1.

Mind you, power, authoritarianism, patriarchy, and domination are one and the same thing so that, in human rights learning (HRL), the determinants of domination are analyzed. Health professionals have to understand this and furthermore understand that they do have the power to change things; they have the power to question, the power to propose their own answers … the list of what they can do is long.

This is where HRL zeroes in to begin with so that, eventually, counter-power, by necessity, is oriented towards finding the best means to bring about corrective actions that address the human rights of most claim holders. For this to materialize, socially minded academics that are determined to engage in organizing humanizing, action-oriented curricula will need charisma—and power within curriculum committees; they need to be convinced of the relevance of what they want to change, pushing to stretch the limits of the possible, if needed; and for that, they must be courageous.

Activism, profession, compassion, and solidarity

In their work—and not that this is easy—the idea is that diagnosis, treatment, compassion, and social solidarity become one and the same thing for health professionals. This is why I aim at persuading students and faculty in the health professions to spend more time and energy on HRL. We need to build up this capacity in future professionals. Apathy can and does lead our academic work into stagnation. Ultimately, the need is to transform apathy into a praxis that includes new social relations with patients in their claim holder role, i.e., actively demanding their human rights in front of authorities (duty bearers in HR parlance).

Attention simply has to shift from just ‘treating indigent patients’ for their ailments to a deeper understanding of the deprivations leading to those ailments rooted in issues of poverty and inequality with their underlying processes and structural causes. What ultimately counts is health professionals’ social accountability to their patients so as to work in true partnership with those they serve.

Academics also need to explicitly recognize and understand how social processes and issues of power determine the content, direction, and implementation of, specifically, health care and health programs. Together with those that the prevailing health care system marginalizes, acting as claim holders, human rights-responsive professionals can and ought to become strong players instead of implicitly protecting narrow group interests through their work under the wings of governments, hospital corporations, pharmaceutical houses, insurance companies, and international agencies that are most often unmindful of the real interests and needs of those rendered poor, despite their public statements to the contrary.

It is ultimately the networked strength of academics in the health and nutrition area that will achieve the needed curricular changes that will eventually begin reversing human rights violations, not only in health but in all domains.

What must keep more and more academics persevering in this effort is the fact that, ultimately, human rights lend legal and moral legitimacy and a sense of social justice to their practice of health. It is by applying a human rights lens that health and nutrition work will be understood as unequivocally being people-centered.

In the end, it is patients that have to be made bona fide claim holders, so they have to be made to understand that they have power as well, i.e., the power to question, to claim, and to struggle for their rights1.

Academia needs leaders that engage in organizing for a more humanizing healthcare curriculum and praxis—and that can mentor students from early in their professional education. HRL added to curricula will be a step in that direction2.

Finally, and not to be naïf, I am not talking about the need of an unrealistic allotment of time in the curricula of health professionals to cover human rights, right to health and right to food issues. There is no prescription here. What is important is that there is a tutoring approach to this learning with ample discussion time, case studies, and time for students to tell where they are coming from on social justice issues. Contents can be accessed online through self-study with only some guidance. Last, but not least, faculty members with the right background have to be engaged.

The challenge for students: out-of-date curricula

Students seeking a degree in health or nutrition should (but do not) have opportunities to see how their field can impact human rights—both positively and negatively. For this, students will need experiential education opportunities that they seldom get. Most universities do not see active engagement in human rights as being central to their mission. Many university departments are enthusiastic about human rights education but do not apply that to real-world advocacy and activism because it is seen as ‘too political.’ The reality thus is that few professionals have been able to add their genuine interest in human rights into their practice.

Many communities are without access to the kind of human rights knowledge they need to better and more actively engage in the protection of their rights, very importantly including the right to health and to adequate food and nutrition. Breaking this status-quo will require incentives for professionals to take concrete actions that avoid them (knowingly or not) being complicit in human rights violations3. The underdogs need to go through a stage of gaining a new consciousness that allows them to see the great costs to them that the dominant system imposes.

Thinking out loud

Most of our lives are spent learning what other people have told us to learn so that change has occurred relatively slowly. Is this one of the causes of our inability to effectively diagnose and respond to increasingly rapid and negative globalized changes? For sure, we have not met the challenge. The reasons are multiple but generally reflect a narrow-minded view of disciplines that originates from conservative academic leadership and from the lack of a collective ability of traditional academics to recognize the importance and to react to the negative impacts of globalization4.

Notes

Schuftan, C. “Nurses, Public Health, and Human Rights: Their Role as Claim Holders, Duty Bearers and Promoters of Social Change.” Creative Nursing, Aug 2021; 27(3), pp. 163-166.
1 Nicola Philips, Power and inequality in the global political economy, International Affairs, Volume 93, Issue 2, 1 March 2017, Pages 429–444.
2 Google. (n.d.). Right to health curricula. Google Search.
3 OpenGlobalRights. (2023, February 2). Human rights education and career opportunities for scientists could foster systemic change. OpenGlobalRights.
4 William Bertrand, Higher education and technology transfer: the effects of “techno-sclerosis” on development, Journal of International Affairs, Fall/Winter 2010, Vol. 64, No. 1, p. 101-119.