Engaging with the System - A Visit to IISc

When Prasanna heard John and I were leaving Hari's farewell party to join Ravi in the trip to Indian Institute of Science, PS let out a characteristic sigh and said "all the best". It probably comes from experience of how incorrigible people in elite institutions are when it comes to thinking about broader determinants of health and communities.

After all, I wasn't wearing my usual grey short pants either. I had to dress for the "vibe" of the place. I was wearing a long pant and a full sleeve shirt. Even Ravi was wearing a shoe. And when we reached the place, we were welcomed by Dr H Paramesh who was wearing a suit. The only person who was under-dressed (relative to their usual) was Pruthvish who was at the venue too, but didn't wear a suit today.

Places and events like these have a way of making you uncomfortable in your skin. There's a level of "sophistication" that's expected in the way you carry yourself. Is it written down anywhere? No. It's just the air. You won't be able to breathe if you're not walking and talking the way everyone around you is.

Gender non-conforming people have stated how in public places, it is sometimes overwhelming for them when everyone is looking at them like "they don't belong here". Trans women feel unwelcome in healthcare clinics for similar reasons. 

Perhaps what I feel is a bit like what they feel.

Would you expect a trans woman to speak about "Health for All" at Indian Institute of Science? Or a garment factory worker? Or a manual scavenger?

I wouldn't. Because they would always be under-dressed. No matter how expensive their clothing is.

It affects the content of the discussion too. There are certain "sophisticated" ways you would give a talk in a place like IISc. You can talk about things like "equity". Even "gender equality" is fashionable. But words like "caste", "transgender", etc would not pass the vibe check.

That's the trouble I frequently have when "engaging with the system". The system has certain methods. And certain taboos. It is often the taboos that are at the heart of the problem. 

It is only if we talk about the terrible lived experience of the caste oppressed, or the gender minorities, or the poor that we can start to expose how unjustifiable the position of scientists in ivory towers are. When lived experience of discrimination and oppression and ill-health is put on the table, people will have only two options - either turn their faces away and ignore it, or accept how they are part of the problem. They can no longer sleep comfortably saying "we're also doing our bit". Because nobody is doing their bit as long as people are suffering.

And those who are suffering will never be invited to talk to the system.

The responsibility then falls up on those who are invited. To give a second hand account from their experience of the lived experience of suffering. To amplify the voices of the marginalized. To pass the recording, when they can't pass the microphone.

But that won't pass the vibe check.

A Community for Online Action in Community Health

Today Guru, John, Swamy, Ravi, and I met in the Health for All - Learning Center workspace at SOCHARA. We discussed an action plan for the next 3 years (with a focus on 2023-24) for the Digital Archives Platform unit at SOCHARA. The archives becomes a core activity for a community of community health activist-scholars and activist-professionals to do study, reflection, action, and experiment online towards "Health for All". 

The larger hypothesis is that when we flood the internet with content related to community health, the second order and third order effects of that will lead to a massive movement by narrative building and discourse shaping towards community health.

The DAP at SOCHARA is going to focus on SOCHARA's own reports, publications, presentations, videos, audios, etc for the first year (along with medico friend circle's archive). This comprises items from Appendix A of Silver Jubilee Museum Archive Project that happened between 2016 and 2022. The year after that we will focus on Appendix B (which includes networks and organizations SOCHARA is connected to) and Appendix C (which has special focus themes and topics). What to do in year 3 will emerge by the end of 2023.

While this is just the Digital Archives part of it (which many organizations are now entering - NCBS, AICTU, APU, WIPRO, etc), there are many many other activities that this community can do:

  • Communications for community health with things like podcasts, memes, reels, and so on need to be built.
  • Stories of people and organizations need to be captured on wiki.sochara.org (which communityhealth.in now redirects to).
  • A public discussion forum needs to be created (either as part of something like Azad Maidan or independently).
  • Content of high quality and relevance like mfc bulletins and health taskforce report need to be modernized by conversion into web pages with hyperlinks.
  • Effective sharing of resources with other similar efforts in the network has to be accomplished.
  • The team at SOCHARA itself has to become comfortable with and active on these public documentation efforts.
  • ... (your idea here)

There's plenty of interesting work that lies ahead. This month we will be focusing on the website and SOCHARA's evolution story, physical clean up of the unused sections of the library, and getting "systems of sustainability" available for use of the team.

Two tables put together with half a dozen chairs around it. Bookshelves filled with books are all around.
The workspace in HFA-LC, after the meeting. I forgot to take a photo while the meeting was happening. The empty chairs symbolize the space for anyone reading this to come in and be part of the community.

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I am a general practitioner rooted in the principles of primary healthcare. I am also a deep generalist and hold many other interests. If you want a medical consultation, please book an appointment When I'm not seeing patients, I code software, advise health-tech startups, and write blogs. Follow me by subscribing to my writings