What is mfc?

A year ago, I asked in mfc's own e-group this question. You can read that long email and another long email after a week with more ideas of what mfc is here. It ends with an appreciation of what the website presently says about mfc:

It is an organization which has operated for forty eight years as a ’thought current’ without allegiance to a specific ideology. Its only commitment has been to intervene in and understand the debates, policies and practices of health in Independent India. The understanding that our present health service is lopsided and is in the interest of a privileged few prevails as a common conviction.  It has critically been analyzing the existing health care system and has tried to evolve an appropriate approach towards health care which is humane, and which can meet the needs of the vast majority of the people in our country.

[If anyone knows who wrote this, please let me know]

Of course, this has to be updated to say "50 years" now because mfc just had its 50th annual meet at Sewagram last week.

In the 49th annual meet during the general body meeting there was a comment by someone that they didn't want people who ask things like "what is mfc" [in a mocking tone] in their volunteer group for 50th year meet. Funnily enough, the 50th meet and the bulletin released was revolving around exactly this question on identity.

Ritu Priya's article was titled "The Debt I Owe to MFC as the ‘Informal University’"

Anant Phadke's article was titled "My Reflections on MFC A Consistent Yet Feeble Pro-People Platform in Health care; The Fee-less, Open University of Community Health"

Sathyamala quoted from their own previous editorial

MFC is an organization. No, it is a circle of friends. No, it is a thought current. No, it is not even an effective thought current. MFC should debate issues. No, mfc should act. No, mfc is only for Mitra Milan. No, mfc should take stands. MFC has missed the bus. MFC members are unfriendly. MFC is like a family. The Bulletin serves no purpose. Bulletin must continue. Close the Bulletin. The Bulletin is MFC’s life line. Let us decide once and for all what is mfc. How can we decide once and for all what is mfc? MFC is not professional enough. MFC is too elitist. MFC which way to go, which way not to go. (Sathyamala 1998)

Sathya then goes on to call mfc as an "epistemic community".

The rest of the articles are also about what expectations from mfc have been and what mfc have been able to or not able to do.

Similarly, in the meet, there was a session about mfc and its future. There was the idea of forming a steering group to define a constitution for mfc and decide on questions like maintenance of website, bulletin, etc. The Q&A session here also spent considerable time in the question of what mfc is. This took the form of a debate between mfc defined as a "friend circle" and mfc as defined in the brochure:

The Medico Friend Circle (mfc) is a nation-wide platform of secular, pluralist, and pro–people, pro-poor health practitioners, scientists and social activists interested in the health problems of the people of India. Since its inception in 1974, mfc has critically analyzed the existing health care system and has tried to evolve an appropriate approach towards health care which is humane and which can meet the needs of the vast majority of the people in our country.

In this post, I'll look at this issue once again and try to define what mfc is, or at least what mfc is not (as Ashok Bhargava once suggested).

***

Before we go into that, we need to discuss a couple of things about defining mfc.

Firstly, defining what mfc is and defining what mfc should be are two different things. What mfc is is a (difficult) question of describing the reality of mfc as close to possible which can be done by anyone who has spent sufficient time observing mfc. What mfc should be is an even more difficult question which requires consensus and vision, and brings up plenty of other operational issues. In this post I'll focus first on defining mfc, and at the end venture slightly into what mfc should be.

Secondly, what mfc is and what mfc did are two closely related yet separate questions. Plenty of times people equate these questions and end up in a soup. The answer to what mfc did is indeed useful in understanding what mfc is. But if we just rely on what mfc did to define what mfc is, we will land up in improbable expectations from it.

And finally, defining mfc is an attempt to seriously engage with mfc and should not be seen as an attempt to diss mfc.

So, let us first look at what mfc is not:

...an organisation coming together for collective action at times of a crisis

Yes, mfc did it. During Bhopal disaster, mfc came together for collective action. During carnage in Gujarat in 2022, mfc came together for collective action. For access to drugs, AIDAN was formed collectively. But these are things that mfc did. There's no guarantee that mfc will come together at times of a crisis. Manipur and Gaza were made discussion topics at mfc annual meet in Feb 2024 probably in an effort to resume this collective action. But that's not what mfc is. mfc is not an organization meant for action. It doesn't have a budget. It doesn't have any paid staff. It is not meant for any action.

...an epistemic community influencing health policy

Yes, many people from mfc did participate in the run up to National Rural Health Mission. Yes, people from mfc have done judiciary activism. Yes, mfc has a big role in JSA. But mfc cannot be an epistemic community because an epistemic community is a network of recognized experts. mfc has always been open to anyone - expert or not. Of course, mfc does include experts who could form an epistemic community of their own. But mfc also includes non-experts. And therefore, by definition it cannot be an epistemic community. 

...a friend circle

This is probably the hardest to convince people in mfc that mfc is not. Even people who don't want to define mfc primarily as a friend circle will say that it is indeed a friend circle, at least secondarily. I believe that this definition of mfc is also in the realm of what mfc did and also what mfc should be, rather than what mfc is. To define mfc as a friend circle, though, would be stretching the definition of friend circle. Sure, I have made and nurture several deep friendships through mfc. But mfc is primarily composed of strangers. In the e-group, as of today, there are 716 members. I barely know 50 of them. Most people in mfc don't know most people in mfc. There are also people I find annoying within mfc. People I would never call friends. It is very difficult to call mfc a friend circle, no matter how warm the environment is and how friendly people are.

...a think tank

Think tank is defined as a "group of experts brought together, usually by a government, to develop ideas on a particular subject and to make suggestions for action". mfc disqualifies for reasons mentioned above under epistemic community.

 ...a thought current

If you read the emails linked above, you'll see that the word thought-current itself is a buzzword that leaves us no further than what we began with. If you define thought-current as think-tank above, then mfc doesn't qualify. Basically, it is a circular definition.

...a platform for exchange of ideas related to people’s health

This probably would have been a nice definition for mfc in 1970s and 80s assuming there was no other platform for exchange of ideas related to people's health. But in 2024 when you have plenty of avenues for publishing ideas and exchanging it with the rest of the world and instantly getting feedback thus furthering the exchange, to call mfc a platform would be demeaning the word "platform". Of note is also the fact that mfc had a barely functioning website till last year. mfc continues to not have a social media presence. It is very difficult to convince someone interested in people's health in 2024 to join mfc for exchange of ideas.

What is mfc?

Let me reiterate what I said above. By discarding these "definitions" I'm not trying to say that mfc has not served these roles or that mfc should not be these things. I'm simply trying to say that mfc needs to be defined more accurately to represent the reality.

At this point, it would be a disappointment if I didn't present an alternate definition.

Let me first document a couple of definitions that I discarded.

I had tried to draw an analogy to an alumni association. An alumni association is just a group that exists because of some historical coincidence. It doesn't have particular objectives or structure. It is just a group that exists, have shared nostalgia, etc. This doesn't accurately describe mfc either.

Then I thought about saying "mfc is a hashtag". mfc is like a hashtag people use on twitter where there is not much of a structure, but things could happen sporadically. And there is a lot of discussion around the same hashtag. But then I found something better (thanks to AI)

mfc is a community of interest

Wikipedia says the following:

A community of interest, or interest-based community, is a community of people who share a common interest or passion. These people exchange ideas and thoughts about the given passion, but may know (or care) little about each other outside this area. Participation in a community of interest can be compelling, entertaining and create a community where people return frequently and remain for extended periods. Frequently, they cannot be easily defined by a particular geographical area. 

The difference from epistemic communities and "community of practice" is that in community of interest, expertise is not a pre-requisite. Anyone can join a community of interest.

Let's not forget what a "community" is: "A community is a social unit (a group of living things) with a shared socially significant characteristic, such as place, set of norms, culture, religion, values, customs, or identity."

mfc is a community of interest that's formed around the shared interest of a pro-people, pro-poor health system. Experts and non-experts are welcome to participate. The main mode of exchange of ideas in mfc have been through yearly meeting, publishing a bulletin, and discussing on an e-group, all organized democratically and with a spirit of friendship that transcends ideological divides.

mfc going forward

I would have to be the kind of academic I hate to describe something to great detail and do nothing with that.

Going forward, there are a few things I would like to do with/through the mfc community (that should be the name!):

1. Tap into the knowledge that is embedded within individuals in the mfc community and make this tacit knowledge more explicit through discussions that are centered around such knowledge — for example, knowledge on how to solve some of the problems encountered while traveling towards Health-for-all.
2. Surface individuals and groups that are setting good examples into the public consciousness through corrective and creative use of powerful tools like the internet.
   
3. Develop the strengths of mfc as a healing community for saving disillusioned medicos from anti-people healthcare system and manifest in them the vision of a pro-people health system and the skillset required to reach there.
4. Embrace the concept of an open/informal university and bring together all groups/individuals with similar thought-processes (SOCHARA, CMC Vellore, THI/travel fellowship, etc) to double down on the concept of open/informal university and internet based pedagogies.
5. Nurture the/a community of practice within mfc that serves as a reliable knowledge respository for communities of action like JSA and SAA-K.
6. ...
7. ...
8. ... 
9. ...
10. ...
    

References

• https://www.perplexity.ai/search/What-do-you-fap4YqMJRnStnJtgFGSB9g
• https://en.wikipedia.org/wiki/Virtual_community_of_practice
• https://en.wikipedia.org/wiki/Community_of_interest
• https://en.wikipedia.org/wiki/Community_of_practice
• https://en.wikipedia.org/wiki/Discourse_community
• https://en.wikipedia.org/wiki/Knowledge_community
• https://learnlearn.in/mfc/what-is-mfc/
• MFC Bulletin 383