Thursday, September 28, 2006

The Words of Subcomandante Marcons on "The Other Healthcare"

The words of Delegate Zero (Subcomandante Insurgente Marcos) presenting the inauguration of “The Other Health” sector, April 30th, 2006

Transcription taken without modification directly from audio recording. The translator has made all attempts to be loyal to the content and the style of the original Spanish Version. Where words have been added to explain concepts foreign to the English language, they appear [in brackets]. Original Spanish Version appears on the website of "la otra salud."
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Alright, compañeros and compañeras, well, all of this about “The Other Campaign,” all of this going out to listen to others, has allowed us to discover that the people themselves are organizing in things that we hadn’t even imagined.

In Jalapa, we found, well, a group of scientists of various specialties that were worried about how capitalism is taking over science and making it produce death, when as a scientist, one supposes that s/he is not involved in science for destruction, but rather for preservation and construction. They said that science, and above all medicine, was in a “proceso de maquila” [a process driving medicine to resemble “maquila” or “maquiladora” sweatshop factories, especially those along the Mexican border with the United States]. So, in the universities and research centers, instead of equipping one single project that could really uncover the nature of the “system of death” being studied by the project, they divide it up in universities or in other research centers through the work of corrupt officials or, well, even scientists who put themselves up for sale. With that compartmentalization of knowledge and then compartmentalization within one research center… how secretive this becomes. And the result is that what seemed innocuous or what seemed neutral becomes a bomb. And I don’t mean a bomb that explodes; I mean something that causes harm. And it is probably just like this, as it is in our own universities and research centers, in institutions around the world. They have come to produce many of the sicknesses and ills that are in our country and around the world.

I see two important points with their position. One is how capitalism turns healthcare into a merchandise, and, as administrators of this healthcare, doctors, nurses, and the whole apparatus of hospitalization and the distribution of healthcare, also become a sort of foremen of this business. And they convert the patient, as they used to say here, into a client, a client from whom they have to get as much money as possible without this necessarily meaning that he or she will have better health.

We confronted this problem in the indigenous communities first out of necessity. We aren’t saying that we choose traditional medicine, but that there wasn’t any other medicine. And traditional medicine allowed us to develop on the one hand, but we could not confront the rate of mortality, above all infant mortality, with just our own development as indigenous communities, which is limited by… well… what nature gives us in the way of traditional medicine. Rather there was always that expectation that this medicine didn’t cure; it relieved or controlled the symptoms… and that it is the other medicine, the one in the hospital, the one given by a doctor, man or woman, with that image of being dressed in white… and which in some cases should be dressed in black… that this is the medicine that cures.

When the uprising occurred and we found ourselves with you all, with the men and women in Mexico and across the world that expressed solidarity with our cause, we began to receive help not as if it were just charity or alms, but rather understanding that it was support for a different political project. And we began to meet the other doctors, men and women, and the other nurses, male and female, that helped us to go about constructing within Zapatista indigenous communities so that, according to their own logic, the communities would break with this dependency… So, for example, when we formed our health committees, we didn’t make train them only in herbal remedies or traditional medicine, but also in the application of vaccinations and other medications. But once we are working in this we confront the capitalist healthcare market. It is not possible… We are insisting everywhere that it is not possible to create an self-contained compartment of liberty, justice and democracy. That is why our struggle is national. As much as we advance as Zapatista communities, we are always scraping up against the edges, and this system of exploitation, of exclusion, of racism, and… well… what we are confronting keeps smacking up against us. There are better conditions now than before the uprising. In some zones that lacked land, like Los Altos [the highlands] of Chiapas, medicine is free - the attention and the medicine - and we are trying to address sickness with prevention instead of all going out to attack the sicknesses. And, in this sense, this is one of the few advantages of the structure of the EZLN within the communities, that it permits the efficient implementation of health campaigns in the communities, such as the construction of latrines, their care… There are commissions that ensure that the latrines are supplied with lime, and the person that doesn’t do his/her job is, well, put before the assembly and criticized. They ensure that the children really complete their vaccinations, and that these are administered and obtained by the same community structure, not by the government structure.

Well, alright, there we are, happy that the doctors, men and women, and nurses, male and female, are arriving and that this contact, which is support for a political cause, begins to tell us about what is going on here.

I am going to go slowly to make sure I catch my breath because in a moment they will take me running off to The Other, right? The other meeting, I mean.

So then they begin to tell us about the working conditions in Seguro Social [the Instituto Mexicano de Seguro Social is in charge of, among other things, public healthcare services and care for the elderly and disabled] and in private medicine… Someone from the group of people that were arriving there told us that, when you choose healthcare as a profession, whatever level you are at, you are choosing the profession of life. Its not just a matter of life, but also of fighting against pain. And this person told us that it is a matter of having a special sensibility to pain that keeps one from becoming cynical. And what is happening with the capitalist system is that there are doctors and nurses that are cynics, that can face a person who is dying or suffering a lot and treat that person as if s/he were asking for a pass to see a movie, as if they were working at a ticket counter handing out tickets and could say, “wait for a minute while I drink my coffee” and all that; So we are told that all of this is destroying not just what was the vocation of healthcare or the vocation of medicine but also the image that the population had had of doctors and nurses, (both male and female). And so the doctor or nurse was turning, in effect, into a foreman more all the time, or better yet into a shopkeeper of healthcare, into the person who receives the money, and who gives you the box and says “take one of these.” And one could see that the racist relationship that had earlier been taken to the indigenous communities was moving more all the time into the relationship with the rest of the population. It wasn’t just a matter of if you were indigenous, but that if you were going to a health center and you were already poor, well, you wouldn’t even be there in the Seguro [public hospital) or in that pharmacy, a “popular pharmacy” [this is a reference to a chain of pharmacies in Mexico that sell generic medicine called “farmacias similares”] or whatever they had constructed. And that meant that you were classified as a sick poor person, in other words a poor person that could not pay for the healthcare that you needed, but for whatever healthcare you could afford… enough get you an aspirin or a Tylenol or whatever you want to call it. And that is what the system of healthcare will give you; it will not make you better. And that is how the system was before, yes, in another epoch of capitalism. Medicine – healthcare - was a business. Now with the new era, sickness is again becoming a business. When there are more sick people or more sickness, more medicine is necessary. So then there is the pharmaceutical industry, the shameless or the fraudulent just like the case with this little old man… What’s his name? Dr. Simi, candidate for the President of the Republic, … if there were ever a need for some ridiculousness, there is Dr. Simi to complete the panorama

[Dr. Simi is another recent candidate for President, real name Victor Gonzalez Torres, who owns pharmacies of generic medications called Farmacias Similares and the Laboratios Best that supply the stores with generic medicine. He has also founded discount health clinics and an alternative public health system called SimiSeguro and attacked the Seguro Social public health system with an anti-corruption campaign. After being eliminated from the race for president, he spent large amounts of money to support the PAN candidate Felipe Calderón Hinojosa. Some Mexican media outlets, most notably the magazine Proceso have pointed out that this financial support violated Mexican campaign finance laws. Dr. Simi is also known for sometimes ridiculous promotional gimmicks which add to his reputation for the bizarre].

It was the business of death and pain, the business of healthcare had now been turned into a business of death and of pain, and this was affecting not just health - that people would die or suffer from more sicknesses - but it was also shaping healthcare professionals, or healthcare workers as you all say. This system was shaping them in such a way that what was thought to be good wasn’t to cure a person, but rather to get as much out of someone in the greatest possible amount of time. So it turns out that when you decide to study medicine, if you are going to have a future, you are not thinking about going out to tackle pain and death, but instead about having a good business. Because if there is someone who is going to live comfortably, well, it is a doctor. Who would have said that now we have and will have doctors and nurses and all, as they were saying, acting like taxi drivers or as if they were selling tacos.

This destruction, not only of the healthcare system but also of its labor market, is something that we have to denounce in The Other Campaign, because there is not one serious program about this within the political parties there up above.

Healthcare is just as important as putting up a poster or paying for a television commercial. We know this well… that they make up healthcare programs in such a way that it is really about promoting a political position, and not about tackling a problem. For this reason there aren’t these businesses, the politically-for-rent business of health systems, in isolated communities, because no one goes out there; not the radio, not the television, not Comercial Mexicana Supermarkets, not Sams Club, and so it serves no political purpose. That is why these health services are concentrated in large population centers, and the rest of the population is abandoned. Only when some president or some political candidate takes a trip, then they will inaugurate something. And this is ridiculous if you follow it up, which is what the press doesn’t do, stay there after the government official leaves so you can see that it was just the stone, that there lies the inaugurating stone or that they made the shell of the building, but the doctors never arrived, and neither did the medicine.

There is one, well, documented case of such an occurrence, the Guadalupe Tepeyac Hospital in the Las Margaritas Zone, now the autonomous municipality of San Pedro de Michoacan. Salinas arrived and inaugurated the hospital with a great song and dance and it turns out that the doctors never came. Nor was there any medicine. It was a white elephant, the pure structure, well painted, well adorned with a sign on it that said “Solidarity,” but it never worked and it only really began to function when it was taken over by Zapatista troops. There they began to care, at first, for casualties of war and, later, to offer healthcare to the population until the army showed up and took it over from the International Red Cross.

So we say, if these different sectors are appearing, well, good for the Sixth [Declaration of the Lacondon Jungle] and for The Other [Campaign]. That means that these people are saying, “This is my place. From here we can lay a foundation and here I can find other people that think like me.”

For this reason the spoken word is very important here, to say it, and not just get carried away “off to the races”… which is bad, in addition, because it gives me tachycardia.

Their words are very important, very important, because others are going to hear their words in other parts and are going to say “I am thinking the same thing.” Just as this person heard the compañero from The Other [Campaign] in Hidalgo, there will be others in The Other Campaign in the rest of the country who say “Alright, that’s it!”

Because maybe the workers’ movement doesn’t draw my attention, and neither does the student movement, nor the women’s movement, nor others beyond that, because there are also conditions of concern in my work, and I am in this place, and I think something else is possible, and I feel alone in the face of the general effort. This suggests that The Other Campaign has to unite these voices in the whole country, and, well, even begin to build relationships with other movements in other parts of the world that are suggesting something similar.

If we manage to accomplish this, we begin to discover,… we are going to begin to discover resistances and efforts that we are not familiar with. First because it seems that in “The Other Campaign” … it seems to us that they should continue with their efforts, with what they are doing… complete it… Maybe I am unfair because they have just given me a document, an order for a procedure; maybe it is written out there somewhere. An X-Ray must be done on what healthcare means within capitalism. This process of transformation of the business of healthcare and curing into a business of pain and death… in order to put it up for rent… and along with that… I think that they are going to find even more listening ears, not just in their field, but in the entire population, because they are going to find many more that want to get involved in this,… Alright, it is possible to raise up “the other healthcare” just as they talk about the other economy, the other politics, the other culture, and other information and to make it to a meeting or to a couple of meetings, and make something where they expose these problems and be able to say to all of these people, to all of these men and women in the field, to say to them… to respond better to the question “is this the right place for them?” YES The Other Campaign is the place for all of those from below, all of those who are anti-capitalists.

One of the very important parts of what you are able to put forward is the ability to dissect the current discourse among the political class and specify what is the real purpose with respect to the health of the population,… doesn’t matter which political party. If it is true, as we think it is, that in capitalism healthcare is a business that, furthermore, is fed by the business of pain and death, then in what way are the programs of the various political parties confronting this problem, or are they not? We think they are not dealing with the problem, but if you manage to dissect the arguments, you will pull down the skeleton of supposed political options of this discourse there up above, and not just for the population at large, but also for the healthcare workers.

So then, we think that what you all have to do is,… whatever…. That is the flaw of The Other Campaign, that when somebody says something, its up to speaker to do what s/he says.

I’m wondering around here just to blabber away.

That is what they see from up above when they look at The Other Campaign, in their easychairs, saying that The Other Campaign is a bad option for the left. They look at this as if it were a complaints box. They forget that as soon as someone says that this is the problem, they are committing themselves to saying that there exists an “other” solution, that we are also going to build “the other” solution… This necessarily means that it will be built below among the people, and NOT that we present a list of demands to the candidate that is going to win or is going to lose knowing that there is not going to be any solution, but that in anycase we would have a chat, drink our coffee, have a meeting and take our picture, but not ever get any solution for the people below.

As far as what The Other Campaign is doing now,.. it is better to listen as long as another is speaking, … but once this person has asked for a hand… well, the person who goes around asking people to talk has brought it on themselves,… now you have to go about building something new. Because once one listens to another’s words, and says “Alright, well, let’s do it this way,” well, the other person says “Alright, let’s go, what are we going to do?” This is the problem of The Other Campaign that is resolving itself.

The problem with the campaigns from above, is that when someone asks “What are we going to do?” They answer “Wait, wait, I will do it”… and The Other Campaign has to answer that “WE are going to do it, to go about building that.” And its not about waiting for the moment in which we will all rise up and over throw the government, and so then we are going to start to work in “The Other Healthcare.” Nowhere else are they suggesting this, not even in the indigenous communities with their own problems, not in the workers’ struggle, not with the students, nor with the teachers. We have to go about starting to build this already. And we would respectfully like to ask you that when you are in contact with the scientific research community, “the others,” those that are not swallowing all this that they are going to increase the investment in research, and all of that on the DVD which says who is Lopez [Andres Manual Lopez Obrador, recent presidential candidate for the Party of Democratic Revolution] and that he is a good guy and that he is for real. It is necessary to go about building the “Other Scientific Research” because, they explained all of this to us there in Jalapa about how the maquila (sweatshop) works, and its chilling. This would mean that the research centers of the National Autonomous University of Mexico (UNAM), or of the Autonomous Metropolitan University (UAM) or of the National Pedagogic University (UPN), that they are building models of the annihilation of the human being, … and I don’t just mean the physical annihilation but of its essence as a human being… and maybe there we have to start to investigating how scientific research itself is carried out and discover all of these core values. And I am not taking advantage of the fact that all of you are here, but actually because I see Manuel [Lopez Obrador] over here on this side… And maybe some of us, without wanting to, without knowing it, or maybe we are just lying to ourselves and we do know it, we are contributing to what we think is good, what is noble, what is honest, but in reality we are contributing to the war that is, well, building up…

And when “The Other Campaign” says, what we this is all about here is to take away from all of those at the top and to take it all into our own hands. And the production of knowledge is right now also in the hands of officials, or even worse, not even in the hands of officials, but in the hands of individuals who have simply lent their names to the large companies that are grabbing up this jigsaw puzzle that they have made of scientific knowledge and equipping the other side with it. And the figure of what they are constructing is really cadaverous for millions of people.

We think it is necessary to build this, to build this space. I am sure that the advance of “The Other Campaign” will satisfy everyone that most dislikes meetings in general. I am imagining people who think in some meetings “what is this slimy string of drivel saying? Yes I listen because, I don’t care who told me to be an adherent to La Sexta (The Sixth Declaration of the Lacandon Jungle), I don’t care who told me to come, but I have my problem or I see where I can do this, I have to find others and we must build this space without waiting for the commission of the Sexta or the EZLN but we most take advantage of this first meeting to listen and start to put ourselves into contact with one another.

Well, we ask you, this stage right now is fitting, to look for contact with the scientific research community in the large centers of higher learning to begin to bring up this very real problem.

And lastly, that scientific production – science - also has an element of classism, it also has a relationship of exploitation, of overexploitation depending on who is taking ownership of it.

This myth of neutral science was brought down by the atomic bomb, even before then it was known to be false. We think that scientists from all of the sciences are going to find their place. That all of the sciences, each one is going to find its own place, and then they will be able to say if the world that they are building in “The Other Campaign” is really “Another World.” Its not a question of that we are going to throw everyone under one single flag, but that each person will be building their own space.

Thank you compañeros

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