Each year the Skoll Centre invites a small number of Oxford students to the annual Skoll World Forum on Social Entrepreneurship. Each year they share their unique perspectives of the sessions and events that unfold during this magical time in Oxford.
This session conducted by the leadership team of Partners in Health was scheduled for 7 am on the 10th of April. Hence by design it self-selected for individuals who were extremely motivated to learn from the experience of Partners in Health in Global Health Delivery.
Partners in Health (PIH) is a Boston-based nonprofit health care organization founded in 1987 by Paul Farmer, Ophelia Dahl, Thomas J. White, Todd McCormack, and Jim Yong Kim.
The organization’s goals are “to bring the benefits of modern medical science to those most in need of them and to serve as an antidote to despair.” It provides healthcare in the poorest areas of developing countries. It builds hospitals and other medical facilities, hires and trains local staff, and delivers a range of healthcare, from in-home consultations to cancer treatments.
The session was led by Dr. Joia Mukherjee, and was facilitated by her colleagues Dr. Gary Gottlieb & Dr. Abera Lotha
The session delved into a nuance in global health delivery which are often ignored. Dr. Mukherjee asserted that the successful delivery of healthcare ought to be reviewed through three lenses.
- A justice framework
- Human rights framework
- Social determinants of health framework
The first two are not given their due share of discussion since perhaps as healthcare professionals we feel this is beyond our scope of work however, they are essential to an equitable delivery of good health for all.
The justice framework requires retrospective reflection. Many of the inequities we observe as global health delivery agents are not just because people who we aim to benefit do not know better or that there is lack of will to correct the structural problems that exist. Instead, the source of these issues come from a history of colonization, practices of slavery and exploitation of certain regions by others. The damage from these unfortunate parts of our collective history is immense. While these chapters of history cannot be undone, it would not be prudent to completely forget about these issues as important causative factors towards why certain regions struggle to this day with diseases that the developed world has long overcome. Hence, keeping them in our purview as we think about global health would ensure such injustices are never repeated.
The second framework is the human rights framework. Today we live in a world where almost everything we do, any service we receive or any item we own has input from many different regions. This is especially more applicable to the socioeconomic strata attending this forum or can read this narrative that I write today. When we live in a globalized world of commerce then a question that arises is why our human rights are different depending on national borders. What would be considered exploitation in one country would be considered fair trading practices in another. The world is much more comfortable with utilitarian notions of healthcare service delivery for the poor but not the same yardstick is applied to the wealthy. These are deep-seated, class-based biases that ought to be brought out in the fore and the repercussions of these biases need to be corrected or else the inequities we wish to overcome will always plague us in some way or form. This philosophy of healthcare delivery is reflected in the work of Partners in Health throughout the world. They believe all that they interact within their ecosystems are owed a similar chance towards healthcare services.
Finally, the social determinants of health were also discussed. This is an area quite often discussed and debated on in Global Health conversations. The impact of where you are born, your gender, your education and such all impact health outcomes. This has been researched and well documented. Dr. Mukherjee added a nuance to this conversation though. She proposed that instead of calling it social determinants of health we should label this effect the social forces of health since these socioeconomic markers are not just a correlation but have vector component to them as well hence the relabeling to a “force” would more accurately depict the relationship.
One of the key takeaways from this session was that healthcare is clearly a political and a social issue. And in our respective communities, to enable meaningful healthcare change we must interact deeply with the social and political forces. Meaningful change requires mobilization and that’s only possible once we put our skin in the game by operating beyond our healthcare facilities and embed ourselves intimately with the wider community.
Mohsin Mustafa is an Oxford MBA candidate, a Skoll Scholar and Weidenfeld-Hoffmann Trust Scholar. He is also an entrepreneur who is passionate about the provision of quality primary healthcare. He sees the provision of quality healthcare as a way of enabling social justice and that’s what fuels his passion for work. Mohsin is the co-founder and managing director of Clinic5, an affordable healthcare delivery service for communities in Pakistan. He is currently a Skoll Scholar, Weidenfeld-Hoffman Scholar and MBA candidate at Saïd Business School.