Health and Social Justice: A Call to Action

I live in a small rural village called Fondwa, located high in the mountains south of Port-au-Prince in the Department of Léogane, Haiti. On the surface, my life is not so different from that of the peasants around me. I wake up early in the morning and walk through the market on my way to work. The lack of electricity and running water somehow make my experience more "authentic." I eat beans and rice. Everyday.

Yet, in the work I have done documenting the lives of Fondwa's residents, the fundamental differences are all too clear. When I ask the community's granmoun, or elders, if they went to school, it often elicits a toothless grin and a chuckle. "Where would I have gone to school," they say, "and who would have worked the fields?" They really begin to question my intelligence when I ask what they do for a living-Mwen travay tè-I work the land (of course). When we get to health care, I hear stories that would be harder to imagine had I not trekked down the mountain, across the river, and through the valley to visit my interlocutor's house. "When someone was sick," an elder explained to me, "we would take down a door to use as a stretcher and walk to Léogane, where there is a hospital." Léogane is six-to-eight hours on foot from Fondwa. "The person often died along the way, but we had to try."

I will never be carried on a make-shift stretcher six-to-eight hours to receive medical attention. Health is a matter of social justice because it is a basic human right that is currently distributed according to the cold calculus of an economic market. To take a social justice perspective when considering health care requires a holistic approach, looking at all of the factors that cause health problems. Malnutrition, a lack of access to potable water, unsanitary living conditions, all of these things contribute to poor health outcomes in rural Haiti. Each requires a different response: providing technical training to increase crop yields, using a community-based approach to capture and maintain clean water sources, and educational efforts are all part of a holistic approach to health needs.
This kind of strategy, though it has been proven successful in places like Cange, Haiti, can be daunting due to the shear scope of the difference between what is and what should be. While the paradigm of human rights is an appropriate theoretical conception of health from a social justice perspective, a practical response is required. That response must be elucidated in the way we choose to live our lives, either by the rules of the status quo or participating in the movement to create a preferential option for the poor. I will probably never be a doctor, but that doesn't have to stop me from directly affecting health outcomes in the poor areas where I will surely work. A social justice perspective requires as much.