In recent years, my story starts with attending a social medicine course where I was enlightened on the social determinants of health and my role as a global citizen and a health professional particularly in a world driven by neoliberal economic policy and a biomedical approach to medicine. The agenda of the course though is beyond enlightenment, it is to create a movement, a social movement, a new breed of health professionals who recognise the social and economic causation of disease and should engage in advocacy for social change. From this course, I walked away with new words, phrases and values; conscientization, social justice, liberation theology, pragmatic solidarity, a preferential option for the poor, education for social change, humanity vs humanitarianism, health as a human right et cetera. I am hopeful I have grabbed your attention thus far. If I haven’t, then.I’ll head straight to it. The poor or poorer for that matter have poorer health access and outcomes in comparison to their, economically, better off counterparts. And I am drawn to working for and with the poor both as a medical doctor, and as an advocate.
I must let you know before I go further, that I did not grow up on the street. I hardly ever wore tattered clothes, or spent a day or days without food. My parents rented a house near the national stadium (Uganda) and would soon buy their own plot of land, and build their own house. I went to private school for much of my childhood and was self (privately) sponsored for all the five years of medical school.
I share this story as a background to my vocation as a doctor..which is to advocate for the poor who mostly happen to be the big bulk of my clients, and as a preamble to my struggle to be an authentic health advocate in solidarity, albeit pragmatic, with the poor!
At a social medicine conference in chicago,IL, one attendee asked questions like “did I sleep on the street? Did I ever go days without food? Did I wear tattered clothes?” To her this was the only authenticity to an.advocate for the poor. Perhaps to her, I could only be an advocate against that which I had gone through and persevered and now hoped would change through advocacy.
On a personal level, I struggle with the same sort of duality. I feel a hypocrite at times, a pretender! I have not experienced war or displacement. And I do not line up at the clinic, the tales of struggles to see a doctor at the national referral hospital are to me just that, tales!
But should I first spend the day in a queue to see a doctor to know how tiring it is? Should I first be poor to understand the experience and dismay of a patient having to buy expensive medicines, which she thought were free, at the expense of food and school fees for children at home? I needn’t have to be a health worker earning twenty times less than a politician, and working two jobs to understand why he solicited a bribe!
I needn’t struggle looking for authenticity in my work to help the poor. My authenticity lies in being human, as is the poor human suffering from ill health and poor education. My authenticity lies in not being humanitarian as if poor people or marginalized communities are from mars, but in being human. As a doctor, I am given privilege to be an even better human.
Tatian Muwanga; MBChB