Peace through health
by Neil Arya and Joanna Santa Barbara, Kumarian Press, Inc. (2008)
The area of peace-health overlap can be visualized as the area for restoring and/or
maintaining a harmonious human functioning. Since health is one of society’s most
highly valued goals, it will be granted both social legitimacy and in-kind support.
Healthcare, in its purest sense, is an expression of altruism – caring for others,
sometimes at the expense of oneself. Healthcare workers can be catalysts for
peacebuilding work through their holistic and constructivist approach to caring for
others, their workplaces, and the communities that they are an integral part of.
Considerable progress has been made in understanding the ways in which actors in
the health sector can contribute to peace.
This book promotes the improvement of health and restoration of civility to conflict
situations. The guiding principles for epidemiologic monitoring, cross-cultural
health work, and the tasks of peacebuilding share much in common. Training health
professionals in peace and conflict transformation principles will help those
working internationally and domestically to:
1) Clarify their own goals and values
2) Recognize their knowledge, skills, assets, and deficits
3) Apply the principles and tools of Peace through Health to their own work and
other aspects of their lives (e.g. Peace test, Peace and Conflict Impact
Analysis, Do No Harm instrument, and Peacebuilding filter).
4) Leverage the international community through common standards, integrated
knowledge networks, peer-reviewed journals, and e-curricula.
These tools will engage your own unique knowledge, skills, and values in the
quest for peace. The concept of multi-sector peacework also assists with revealing
how all sectors of society have a responsibility to work toward peace. An emphasis
on mutual understanding, effective cross-cultural communication, and respecting
universal human rights and ethical principles is essential.
Multi-track peacework is a deeper, more comprehensive, and more humane
concept encompassing all the work that society does to bring about and maintain
positive peace. Core functions can include healing/healthwork, building, teaching,
and cultivating) and can be implemented by formal, governmental policy
frameworks as well as more grassroots, nongovernmental, action-oriented groups.
The health track can formally and legitimately add value as altruism, compassion,
and caring perspective to the situation in a way that will be rare from other sectors.
The valuing of science and evidence is important in an environment where myth
and propaganda can be misleading or betray. Hence, six elements that uniquely
position the health track in the peacework process are: values, scientific process,
overlap of peace-health for social good, integrated professional commitment to
community, and international standards of excellence. Three large challenges faced
by health professionals are 1) being perceived as going beyond their expertise and
becoming political ‘advocates’ vs. health educators; 2) typically not trained in the
skills necessary for peacework (hence, leading to failure in conflict situations, losing
legitimacy, and trust); 3) team can also fail if PtH is added to an already
overburdened healthcare team without institutional support or sympathetic
understanding of other agencies in the field. (p. 23-25)
DEFINITIONS
Peace is an attribute of a mutually beneficial and cooperative relationship between
two or more entities in which any emerging conflicts are resolved nonviolently. This
attribute can be extended to humanity and Nature as well as between past and
future generations.
Conflict occurs when two or more parties are pursuing incompatible goals.
War is mutual, mass, persistent, lethal violence (escalation of conflict) involving two
or more groups. It can be useful to think of war, not as a sporadic event, but as a
phase of a war system involving politics, economics, and cultures of countries that is
engaged in ongoing preparation for war which occasionally erupts in spasms of
killing.
Alternatively, a peace system engages the same politics, economics, and cultures for
maintenance of harmonious, cooperative relationships of mutual benefit, law and
civility, and transforming conflicts into healthier states/potentialities.
Health is not merely the absence of disease or infirmity, but a state of complete
physical, mental, social, and spiritual well-being. Jadad et al propose a new
definition of health as “the ability to adapt and self manage” in the face of social,
physical, and emotional challenges.” This emphasizes the human capacity to
cope autonomously with life’s ever changing physical, emotional, and social
challenges and to function with fulfillment and a feeling of wellbeing with a
chronic disease or disability.
Structure of health science thinking is value-based (vs. hard sciences like
physics): Diagnosis, prognosis, and therapy along with an elaboration of
prevention to: primary, secondary, and tertiary. For example, multiple causal
factrs leading to eruption of violence/failure. Shorten the course of war impacts
the risks/injury to affected population. Post-trauma healing and rehab are also
areas for health interventions.
You will want to analyze your perception and assumptions about how violence ,
in any stage of its evolution, has resulted in the situation before you. After
analysis, you will wish to devise constructive ways to lessen the suffering and
heal your patient/population.
You may encounter one or more of the following five value dilemmas:
1. Compassionate desire to help vies with respectful nonintervention.
2. A desire for peace urges us to be nonpartisan in a conflict, while a sense of
justice urges us to take sides.
3. A desire for uniform and widespread peace and justice urges us to establish
and promote universal principles and laws, while at the same time, we wish
to pay attention to the uniqueness of cultures, religions, and societies.
4. Compassion can move us to reject violence, but it (along with other values)
can move us to support armed intervention where populations are
threatened with death and oppression.
5. Our sense of justice may lead us to insist on equity, but this may conflict with
our desire to respect traditional (and often inequitable) traditions and social
structures in particular cultural groups.
Creativity, when combined with healthy dialogue, is a key to facing all the above
dilemmas. This duo often enables us to respect all the values that appear to be in
conflict and to come up with solutions that suit the needs of all parties.
Peacebuilding work can happen at individual, community, state, and
international levels leveraging the ability of the healthcare professional’s position to
foster trust, gain insights into health ways of coping, and restoring realistic levels of
hope. Preventing war and its consequences should be in the curricula of medical
schools, on the agendas and practice policies of public health professionals, and a
priority for collaborating community partners. Effective actions, based on rules of
moral conduct within the physician, nursing, and allied health scope of practices will
impact socialization, well-being, and future intergenerational leadership
development. Peace through Health practitioners need to develop an awareness of
these values as a primary motivator for community engagement, building capacity
for healthy dialogue and active, empathic listening as well as re-humanizing the
systems within which we work, live, and innovate.
Health education is an important area of intervention as a society’s
knowledge of health issues – pathologic processes impacting health, managing
disease/risks, and maintaining integrated public health infrastructure – relates to
the level of health that society can sustain. The teaching of human values, empathy,
cross-cultural communication skills, and social harmony can be construed as peace
capacity building. Learning how to institutionalize practices that maintain peace
constitutes peace education and will have much to do with that society’s level of
peace/health. As social evolution continues, most people still do not fully
understand or use highly effective nonviolent methods of change. When the
concepts were understood, they would be creatively applied to the immediate
situation, usually without amplifying the disorder or escalating the conflict situation.
A corollary of peace education is the cultivation of a culture of peace as promoted by
UNESCO. We see increasing the knowledge of peace in order to accomplish social
healing of fractured societies as a peace intervention in its own right…people are
capable of building their own peace (for their generation) and the more options as
well as role models/exemplars they have to accomplish this, the better.
What draws students (and global public health leaders) to Peace through
Health / Medical Peace Work?
- Unique way(s) of engaging and addressing real-world problems from a medical
perspective
- Challenge to contemplate broader societal structures and determinants of health
(geopolitical, economic, structural violence, social media)
- Offers human-centered / population-centered contexts and may connect local events
with global concerns e.g. food security and healthy diets; pandemic preparedness
- Helps links values of solidarity, social justice, democracy and pluralism alongside
health promotion, disease prevention, and safety/collaboration.
With their enthusiasm, idealism, open-mindness, and networking,
students have been crucial drivers for global health experiences, peace
projects and workshops, human rights advocacy, and scholarly approaches to
policy development, peace operations research, and small-scale social change.
However, with broader and dedicated institutional support, these enthusiastic,
motivated, optimistic, and internationally networked ‘zealots for peace and
health’ should be integrated as full partners with relevant mentors and
leaders accelerating their development!
What do we have to offer?
As the historic UNESCO pre-amble reminds us, “Since wars begin in
the minds of men, it is in the minds of men (and women) that the defenses
of peace must be constructed.”
Micro- and macro-determinants of:
Injury, illness, disease and death
War and conflict
Poverty, inequity
Ecological degradation
Community/cultural fragmentation
Poor governance
Human rights abuses/violations
Wellness and growth
Absence of direct violence
Economic sufficiency, equity
Economic sustainability
Community/cultural integrity
Participatory democracy
Mutual respect, Caring