Health rights in the Constitution Goals to be met
Some sixty years ago, in the aftermath of World War II, the Labour Party in the U.K. implemented the concept of a free National Health Service to cater to the needs of its population. The thought then was
that when the existing ailments were got rid off, the cost of the necessary services would not be very prohibitive. The Americans at that time had said that they could not afford to provide such service to the population at large. Subsequently, during the time of President Clinton then and now of President Obama, the United States is looking at the options of the type of health care that it can provide to its people. The USSR had a good network of health services, but it fell apart at the dismantling of the Soviet Union. The passage of time in the UK has shown that as far as health ailments are concerned as soon as one deals with the existing set, new ones spring up waiting to be cured. However, the Labour Party has confirmed the commitment of the state to provide education and health care to the British people.
We in Nepal are always prone to promises on everything irrespective of whether they can be provided it or not. We signed the Convention on the Rights of the Child, but what we have agreed to do still needs to be implemented. The idea of Health Rights for Nepalis was first voiced by the Nepal Medical Association at the time of the 15th Medical Conference at Biratnagar in February 1991. Having health rights as a fundamental right is all very well, provided that we are sincere to our commitments. Whilst deciding what should be included as a fundamental right in the new Constitution, we should reflect on what we are already signatories to.
The Millennium Development Goals (MDG) comes to mind. Provided the promised help is forthcoming, these should be attainable within the stipulated time frame. These goals, which should be the cornerstone of activities in
the coming years are gender equity, persistence in the fight against AIDS, malaria and other diseases,
improvement in the health of the newborn babies and infants.
Keeping the above three points in mind, one can ponder on what should be the Fundamental Health Rights to be specified in the Constitution. These fall into five main categories: childbirth, childhood, adolescents, women and geriatric care.
The very first is the right to a safe birth which in turn is dependent on the health of the pregnant mother. Following this of course come the correction of congenital defects e.g. heart or eye and learning to cope with the genetic ones. Then comes the right of the differently abled such as those without sight, hearing, locomotion or intellect.
Here comes the right to be immunized against childhood diseases. During the early school years the right to examination of vision and hearing so that the child can compete as an equal with his / her classmates.
Adolescence is a period of maximum danger and risks. Enough health education on prevention and even protection must be done. The rights of women in childbearing and rearing have to be maintained and strengthened.
Old age is the time one develops diabetes and strokes. Care to old age patients with glasses and cataract removal has to be provided. Hearing and mobility aids must be provided to this group to ease the efforts of living. Provision of old age homes with household and nutritional help to provide comfort during their last days on earth are essential.
Recently the Unified CPN-Maoist government of Nepal had tried to provide free health service at the district hospital level. This was a populist measure which though widely advertised had not been fully worked out to make it sustainable. The drugs provided were said to be substandard. Ultimately, it has come to be just a gimmick. Next comes the question of abortions which in certain cases can be a life saving measure for the mother. As far as Nepal is concerned, abortion is allowed as a family planning measure to control our population growth. The Supreme Court made a ruling a couple of days ago stating that the poor who can’t afford it be given abortion services free of cost. Whilst all this is being put it place there are also differing ‘Pro Life’ views of many who consider that abortion by itself is wrong.
It is worthwhile remembering that the world is now a global village of which we in Nepal are a part. Because of the mass usage of information technology nothing is a secret any more and the call is for transparency. We are expected to live and work as per present day norms.
The Universal Declaration of Human Rights - Article 25 stated in 1948 “Everyone has the right to a standard of living adequate for the health and well being of himself and his family.” Later the UN expanded this theme of ‘Right to Health’ further in 1966 and 2000.
In bringing this issue to the fore, my intention is to generate further discussions on this topic. Fresh angles from the consumer’s point of view will go a long way to ensure that our constitution contains what is essential for Health Rights of the Nepali people.