Health has long been a gift that we have attempted to give to the rest of the world. Disease eradication programs, vaccination outreach campaigns, and the Western biomedical system have all been spread to countries near and far. These gifts were often colonialist in design, given without community consent, and without regard to culture or custom. Contrary to Thomas Friedman‘s thoughts, the world is not flat. Rather we live in a world that is increasingly connected by technology, but still remains sharply separated by those who have and those who don’t.

When it comes to global health, we no longer have the luxury of saying, “those people over there have health issues.” There is no simple separation between “us” and “them.” Health problems aren’t over there any more than they are right here. In the US, lifestyle choices contribute to heart disease, diabetes, obesity, and lung cancer. When we talk of disparities in access health in other parts of the world, we cannot forget the glaring health disparities in US inner cities and across communities of color.

The curtain has been lifted and hopefully we have looked in the mirror to see that we too have health issues in our country. While the ideas to make health better have long come from the West and developed countries, that paradigm is no longer applicable to global health today. Our world is still expansive, but we are more connected than ever before. With the internet at our finger tips and friends across the ocean only a skype call away, solutions in global health come from around the world. The past demonstrated that “developed” countries believed they were giving something valuable to those who didn’t have what they had. The result was a plethora of failed aid goals, missing life-saving medications, and decrepit health care systems.

Innovations for better health come from all around the world. It is no longer the “developed” giving ideas to the “developing.” The increasing use of mobile phones have inspired some exciting programs for health records management while SMS and texting have led to revolutions in access to health knowledge and care. However, it isn’t always technology ideas that are most effective. Developing countries have reminded us how important and critical health insurance can be, while at the same time demonstrating the severe need for more trained health care workers. Models that train community health workers, access micro-health insurance on your mobile phone, and social enterprises that provide ambulance emergency services have all been launched in “developing” countries. I can only hope that our health care system can take the time to look around the world for ways to improve.

For many years, complex issues in international development and global health have been tackled by simplified single-issue campaigns that have created short-term “band-aid” solutions. This can be attributed to the limited view most Americans have of the world. For many, issues of global health remain remote and abstract. We, young people, have grown up with the internet in our laps, basic knowledge of different cultures around the world in our classrooms, access to easier communications and travel, and more opportunities to study abroad and participate in global exchanges. These factors have made the world seem more connected, and have bestowed upon us the capability to serve as the key drivers of social change.

We must bridge the divide between rich and poor, privileged and oppressed, developed and developing. We, as privileged young people, can be the voice that changes the actions of our largest institutions to focus on programs that work, projects that benefit people in need, and efforts to build healthier communities.

Reposted from the Blog of Americans for Informed Democracy, where I am writing as a Global Health Issue Analyst.

Before you have anything else, you have your health. Hopefully if you have nothing else, at least you have your health. Unfortunately, for millions across the African continent this is not an absolute fact. Even more unfortunate is the fact that many Africans have no ability to change their health status. They are trapped in a system that is driven by Western market based, profit driven health care systems. As the failures of Western development practices come to light, alternatives to what has been are becoming increasingly visible. These alternatives will form a revolution in African health care delivery. This revolution will be fueled by health care delivery models that will give local communities agency in the provision of their own health care. Community-based models involving cooperative financing, proven para-professional training, new information technology, and social enterprise for the social good will drive the revolution in African health care. People will be able to determine for themselves, their level of health.

What does “Health” mean anyway?
This is a question often left to remain ambiguous. For the purposes of my writing I will provide a comprehensive view of “health” and all that is entailed in sustaining and maintaining health. “Health” in all instances will refer directly to the “basic needs” of a person in regards to health care.

Healing, like health, is obviously rooted in the social and cultural order. [...] To define dangerous behavior, and to define evil, is to define some causes of illness. As the definition of evil changes, so does the interpretation of illness. To understand change in healing, we must understand what it is that leads people to alter the definition of dangerous social behavior. It can easily be accepted that health and healing in Africa are shaped by broad social forces.

As Feierman and Janzen state, health (and healing for that matter) are directly linked to social forces. If a comprehensive understanding of health is to be understood, it must be studied in the context of politics, economics, and other societal structures.

Health is defined by the World Health Organization (WHO) as, “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” The WHO and many other international organizations recognize that this broad and encompassing definition of health. Where this definition becomes ambiguous is what qualifiers meet, “a state of complete physical, mental, and social well-being.” In 1978 the WHO made primary health care its number one objective with the Declaration of Alma Ata. However, even this statement had no clear definition of health or its qualifiers.

Feierman and Janzen provide a more clear definition of the qualifiers of health in the preface to their volume: The Social Basis of Health and Healing in Africa,

[…] it [health] is maintained by a cushion of adequate nutrition, social support, water supply, housing, sanitation, and continued collective defense against contagious and degenerative disease. Such a view is necessary if we are to understand those contexts in today’s Africa where health levels deteriorate, and where they improve.

These authors provide a complete set of qualifiers, or “basic needs,” of health that can be researched further to understand where political, economic, and social structures interfere with sustaining and maintaining health and where health care is inadequate.

Health care should thus be understood as the system and structure that works to provide the above defined “basic needs” to each individual. Often this role falls to governments, but sometimes is taken up by communities and organizations when government’s fail to provide these basic needs.

This blog series will cover four key areas identified that will fuel this revolution in African health care: cooperative financing, para-professional training, information technology, and social enterprise. SCOUT BANANA works to tackle social medicine (social, economic, structures) while enabling others to provide medical services. Be sure to follow closely to learn more!

(photo credit: WDI University of Michigan)

Over the years SCOUT BANANA’s work has been termed “social entrepreneurship.” Unfortunately, the definition of the social enterprise has slowly become muddled and confused with other ideas. During a discussion last month a friend said that calling someone a social entrepreneur was like “cutting the balls off of a socialist.” He may not have been as far from the truth as I once thought. As the term becomes more prevalent within aid and development we must delve deeper into the history of social enterprise and decide what it really means for the work that we do.

Jeff Trexler wrote an excellent post on the history of social enterprise. He writes that a social enterprise is essentially “a venture with a social purpose.” As many wrongly believe the ideas of social enterprise did not come from capitalism or corporate business models at all.

“In socialist jurisprudence, social enterprise was a term designed to replace the capitalist notion of businesses dedicated to the pursuit of profit. The social enterprise generated revenue in excess of the costs of production, but profit-making was not the goal of socialist business–rather, its fundamental organizational purpose was to serve collective benefit. More over, in keeping with Marxist/Leninist ideology, the social enterprise was owned & controlled not by private shareholders–a hallmark of bourgeoise capitalism–but by workers themselves, from the workers immediately connected to the enterprise to society as a whole.”

Jeff continues to write that “social enterprise” migrated to Western minds and charities much the same way that “civil society” was reborn and co-opted. Meaning “citizen’s society,” the term was used to unite individuals against centralized government power. Now the term is best understood as a descriptor of anything “non-governmental.”

It seems that “social enterprise” has drifted just as far from its original conception. As a social venture that was meant to give power back to people and allow them ownership, much like a cooperative, “social enterprise” has best come to represent corporate philanthropy and cause marketing campaigns. Both of which are focused on turning profits and not helping people. Julia Moulden asks, “is making a difference only for the rich?” She easily gives examples that it is not, but is it? As far as the foreign aid/ international development arena it appears that social enterprise is geared towards engaging wealthy Western populations in feel good campaigns, like Product (RED), that are best defined as image marketing campaigns for corporations to try and look better as a way to bring in more customers. Lucy Bernholz has termed this business model “embedded giving” where “commerce is used to generate funds for a cause.” She writes:

“Embedded giving is just one more example of the blurring of sectors and roles between commerce, philanthropy, and public good. [...] Maybe today’s teens and kids who have seen so much embedded giving will grow up to expect that every product and every service comes with a charitable affiliation.”

SCOUT BANANA’s work was first called “social entrepreneurship” in 2004 when I was selected as one of Netaid’s Global Action Awardee and was asked to contribute to a discussion on SocialEdge about young people and making a difference. Then, I was not too sure what the term meant or why it might be significant. More recently Spotlight Michigan has highlighted our work and called us a “social enterprise.” They select “innovative” companies and organizations in Michigan to feature on their website. Their criteria breaks down into three categories: creativity, risk-taking and adaptability. In the true spirit of a social enterprise we are an organization built for adaptation because we operate by members involvement and input. We have always been called creative for our fundraising tactics, use of yellow and bananas, and our ability to connect people. The risk-taking is another story. We never faced any risk in our venture to make a difference. If we failed the only people who would potentially suffer were those relying on our support to access basic health care. Alanna Shaikh wrote an excellent piece on how “global health is not about altruism.” While our actions may have been seen as risk-taking, we really work to create accountable, long-term relationships with communities developing their own sustainable solutions.

Personally I define social entrepreneurship within its original conception; a socialist structure (for social good) that is meant to give power and agency back to people as well as present an alternative to ineffective governments. Civil society still exists because honestly the government can’t do it all and often are not very good at meeting the needs of people. SCOUT BANANA sees the world’s problems as a simple equation of connecting communities; linking the necessary social capital (people and ideas) to social problems. We embrace the idea of “social enterprise” by focusing on presenting an alternative to government aid schemes and other big philanthropy and development programs that go for the quick-fix, band-aid solutions without being people-focused to produce long-term social change.

Is SCOUT BANANA a social enterprise? Yes and no, it depends how you define the term. If you are thinking of an organization cooperatively owned and operated by its members, focused on providing an alternative to what hasn’t worked, and supporting community-based solutions that do work – then, and only then are we definitely a “social enterprise.” In her Spotlight Michigan article I think Caitlin Blair put it best: “A society of entrepreneurs and innovators simply could not exist without social entrepreneurs because where business entrepreneurs typically work to enhance markets, social entrepreneurs completely transform the necessary infrastructure and attitudes of a society.”

See our features on Spotlight Michigan:
profile
article
photo essay