A Summary & Reflection on “Health & Gender Equity in a Period of Global Crisis”

Summary of DSA Ireland Conference 2013

Galway Bay Hotel, Salthill, Galway, Ireland

November 28-29, 2013

Summary & Reflection

Thursday, November 28

The conference was opened by a politician, Olivia Mitchell, T.D. She said that while politicians made policies, they relied on experts to guide them. She said that in all her years, she could count on one hand the number of approached by academics to influence policy. She suggested that researchers should lobby their parliamentarians.

Day 1 Session 1 Opening Plenary: “Development 2.0”

Sally-Anne Kinahan (Deputy Gen Secretary, Irish Congress of Trade Unions) talked about the impact of the financial crisis on employment and fair work. There has been a decline in employment standards and those most vulnerable are women, youth, migrant workers and minorities. She would like to see in the post-2015 agenda: a) full employment and decent work for all; and b) social protection for all.

Dr. C. Rammanohar Reddy (editor of Economic and Political Weekly) analysed the state of democracy in India with reference to poverty and development. He suggested that while the general view of Indian democracy was that it was strong and vibrant, in fact it was quite divided. He detects a ruling elite who realize that they need to work via the state and provide some basic social provisions. He is concerned over the huge inequalities and the multiple deprivations based on a) caste, b) class, c) gender, d) region and e) rural-urban. He detects a desire for authoritarian rule; sees it as a dark cloud on the horizon. However he also sees that there are spaces for influence by civil society and sees their hand and input in the National Rural Employment Guarantee Act and National Food Security Act.

Sue Branford (editor at Latin America Bureau) saw some interesting patterns under the Workers Party of President Lula and his successor. The conditional cash transfer/social protection measure, the Bolsa Familia has helped to reduce poverty and to create a more equal society than in the past. But people are not happy with that. They complain about lack of improvement in the sectors of health, education and transport. They also seem to be disappointed by the lack of change in the basic economic and political model in Brazil.

Professor Ronaldo Munck (Dublin City University) spoke about the nexus between migration and development, noting that internal migration was larger than international. He spoke of ‘the precariat’ and the precarious position of migrants, remittances and remarked that while individual migrants make choices, society chooses migration policy. Migrants had large vulnerabilities in times of crisis.

Fr. Michael Kelly Annual Lecture

On Thursday evening, the Annual Fr. Michael Kelly Lecture was held and Fr. Michael spoke as powerfully as he always does on the subject of HIV and AIDS. He acknowledged the progress but stated that HIV and AIDS are not over and we should not be complacent. He honed in on the link between gender inequality and HIV and made a number of powerful statements: 1) Society gives women an inferior status; b) Total transformation of gender norms is needed – that the current status dishonours and debases us all; and c) Equality between men and women is a realizable dream as it was for Martin Luther King in his ‘I have a dream’ speech 50 years ago. Why not?

Friday, November 29, 2013

Day 2 Session 1:  Gender Equity and Global Crisis

Professor Diane Elson (Dept of Sociology, University of Essex)

Diane outlined her view of three key spheres in society: a) Finance, b) Production and c) Social Reproduction. She feels that the root cause of the economic crisis is the domination of Finance over the other two spheres. Diane outlined a strong analysis, from a gender perspective, of the dangers of looking only at the quick impacts and not looking at the longer-term, slower and often hidden structural changes to employment and longer-term impacts on the spheres of production and social reproduction. In terms of the latter, it seems that homes/households have been asked to bear a heavy burden but with less support from the state to do so. There is emerging evidence of permanent damage to things like the gender wage gap, depletion of human capabilities visible in things like malnutrition, ill health, mental illness etc. The critical thing we need to do is to make the Financial sphere useful to the other spheres of life.

Dr. Una Murray (Consultant and part-time Lecturer in Development Studies)

Una gave quite a broad ranging talk on gender equity in institutions. She outlined the four dimensions of food security and the important gender dimensions of these. She felt that leadership in institutions and strong political backing is needed to achieve gender equity. Crises are harming progress but so are the attitudes of staff in development institutions. She feels that social protection is a key tool to be used to promote equity.

Dr. Simel Esim (Chief and Senior Specialist, Cooperatives Branch, ILO)

Simel told us that cooperatives were making a comeback and provides us with lots of examples. In times of crisis, especially where there is market or public service failure, people often take things into their own hands and form cooperatives. She suggested that some of these new cooperatives, especially those in the financial sector, were interested in negotiating different models. She made some interesting suggestions about how cooperative methods could be taught alongside competitive models in professions such as the law and pharmacy. Her talk suggested that innovation was strong in times of crises but my own reflection was that we seemed to have lost the key lessons on community-led development and cooperative processes and institutions.

Day 2 Session 2: Health Equity and Global Crisis:

Finola Finnan (Head of Programmes, Trócaire)

Finola brought us through progress on the MDGs, especially health targets. She pointed out the progress and where we can do better. The things we continue to worry about include: financing for health, the volatility of aid, some results-based management and funding for wider care and support services. She felt that the lessons we should learn from achievements in the HIV area were: the importance of leadership; the mobilisation of people living with HIV and civil society; strong use of data and evidence to convince… but we also need to stay the course! From a Trócaire study on people’s views of the post-2015 agenda, they found that people wanted three key things: a) accountability; b) respect; and c) equality.

If we are to address the structural problems with health, we need to name them (and Dr. David McCoy did just that!).

Dr David McCoy (Centre for Int’l Health and Dev, University College London and MedAct)

To display progress on the MDGs, David showed us a glass half full of water. He argued however that we should have done much better on the MDGs than we have done because progress in other areas (reducing poverty, financial flows, information flows) should have enabled much more progress. He suggests that while the glass looks half empty, perhaps it is only a quarter full! He then quoted work done on the structural determinants of health and summed these up al originating in economic structures and systems. He then proceeded to outline the threats of illicit financial flows; growing absolute numbers living in slum environments; water, food and energy crises; climate change, militarization and the nuclear threat (it hasn’t gone away, you know!) and suggests that the threats to health gains and health equity are very high. He then identified three “underlying pathologies”: a) Inequality; b) Democratic failings; and c) Neo-liberalism. He suggested that if these are the underlying pathologies, then we are not pushing hard enough for radical and transformational change. He as founder of MedAct, an organization of health professionals, has taken an ‘academic activist’ approach to these problems, hoping that the credibility of health professionals, strong use of data and policy analysis will render them effective and not labeled as ‘loony left liberals!’

Conclusion:

The purpose of DSAI is to promote challenge and debate. This conference has delivered on that in a big way.  We were left with big challenges by a number of speakers:

• Total transformation of gender norms (Fr. Michael Kelly)
• Radical and transformational change (Dr. David McCoy)
• How do we make Finance work for other spheres (and women)? (Prof. Diane Elson)

These are enormous and important challenges. They are depressing and seem insurmountable. There are many of us working in NGOs who understand that the current economic system and parts of our social systems are major structural problems but we want to know what to replace them with. We are interested in ‘the how’. How do we fix these problems; what alternative models are out there? This would be great input from the academic community.

But the conference also cast light on areas of hope. Examples include:

• cooperatives and the voluntary action that underpins them;
• the voluntary action and activism of NGOs and other CSOs;
• the leadership seen in the HIV and nutrition spheres over the last decade;
• the power of data, evidence and strong analysis;
• the continuing spaces to influence government policies; people’s movements
• sensible, galvanizing action from professionals using evidence, their credibility and authority in line with the ‘academic activist’ approach.

The challenges are huge; who will address them in new and different ways?
If not us, then who?
The stage is set for vibrant DSAI, IFGH and Gender ARC discussions in Ireland.