“You are a Professor of Latrines… Shut up!”
Prof. Miriam Were had studied the pattern of hospital admissions and noticed that 80 % of cases were not just preventable, but were infectious diseases acquired mostly through the oral-faceal route. To prevent these needless admissions, she was advocating for building latrines as a key element to promote hygiene in the communities in Kenya. Yet, for this well-intended advice, Prof. Were was derogatively labeled the “professor of latrines.”
It wasn’t the first time she was ridiculed. Earlier, during her academic journey, she had chosen to undertake research on people’s participation in community health. However, her supervisors were not impressed.
They told her that is not an academic topic and she must look for an academic topic. She refused and thought they were going to throw her out. Her effort was to make sure that the problems were manageable.
She adds: “The thing is, there has been a lot of resistance, but COVID-19 has dawned on us all and community health is now respected.”
Prof. Were, Co-Founder of UZIMA Foundation-Africa, narrated this sad experience during a webinar on Health is Made at Home, Hospitals are for repairs – Mutual learning between Africa and Europe. The webinar held on December 15, 2020, was hosted by the African Center for Global Health and Social Transformation(ACHEST) in partnership with the African Forum for Research and Education in Health (AFREhealth) and Lord Crisp Nigel the author of the book “Health is made at home, hospitals are for repairs.”
The event also marked the official African launch of the book.
Prof. Were joked that had this book been published earlier in the 1970s, it would have perhaps made her early work in health promotion much easier. Even with milestones along the way, she noted that the problem in most countries is the stiff competition between critical health care and investing in the creation of health.
She called for the need for a Global Fund for Integrated Primary Health Care to help Africa advance the Universal Health Coverage (UHC). At the same time, a global UHC movement would also make a huge difference in ensuring that Africa achieves its targets, Prof. Were noted further.
Lord Nigel Crisp told the webinar that the expression “Health is made at home, hospitals are for repairs,” is borrowed from the ACHEST Executive Director, Prof. Francis Omaswa. While working as the Director General of Health Services at the Ministry of Health Uganda in the early 2000s, Prof. Omaswa invented this captivating slogan to inspire Ugandans to take charge of their health and lives in their households.
Lord Nigel explained that the book was about creating health in the home, the workplace, the school, the community, and wider society. It is also about creating the conditions for people to be healthy and helping them to be so. “We should be interested in the causes of health, not just the causes of disease or illness. Health is much bigger than just the concept of repairs,” he said
Lord Nigel added: “COVID-19 has made the point for us to some extent. We see in our countries people suffering greatly. We see the social issues having a very great impact, people with poor job security and housing suffering. It has really revealed to us some of the inequalities that are outside our health system that impact our lives. The WHO definition of health is about physical, social and mental wellbeing and not just the absence of disease.”
Another panelist, Abigail Kazembe, the President of AFREhealth observed that the curriculums of the health professionals training dwell heavily on diseases than on health promotion. Thus a review of training programs was essential. She added that even for grants, “It is rare to see a grant on how to keep people healthy. They all focus on diseases.”
Kazembe emphasized the need to tailor health creation programs to the specific needs of communities. Citing the handwashing campaign, for instance, she, like Prof. Omaswa, argued that access to water was a luxury in African communities.
The third panelist, Heather Henry Founder of BreatheChamps in the UK, gave an emotional account of the work she has done in communities that empowered people to deal with not just personal challenges but also transform society.
“To harness the power of the people, look at them as an asset,” Henry said, adding, “I no longer inject medicines but I inject confidence.”
Prof. Ged Byrne, the Director of Global Engagement at Health Education England, reflected on the change in discourse; moving away from treatments, the delivery of care, and the role of therapeutics; to discourse around health and wellbeing.
He credited the panel for its leadership and wisdom that will inspire generations.
“It strikes me that the emphasis is on the individual and the family as the focus of wellbeing. Not as an organization or policy. What we are talking about is a change in behavior for all of us. The ability to be able to change, the motivation to be able to change, and the opportunity to actually change,” Prof. Byrne.
Prof. Omaswa, who chaired the webinar, remarked: “ We are building on the constitution of the World Health Organization, Universal Declaration of Human rights, Alma Ata declaration, health for all, the Astana Declaration and the UHC movement. I am very convinced that this book puts us in the right place in this movement to achieve UHC that leaves no one behind.”
Compiled by Carol Natukunda, Communications Specialist, ACHEST