Dr. MeghRaj Jagriti is Board Member of Abundance. Here he talks to Dr.Deepa Pullanikkatil, Co-Founder of Abundance on his journey with Abundance and about his passion – Global Health Access.
Deepa: What does the word "Abundance" mean to you?
MeghRaj: There are a couple of ways of looking at this world, Much of the population of the world is living in such a dire need for everything, in absolute deprivation. And I think the mind is conditioned in such a way that people do not see hope because there are so overwhelmed by their needs and the lack of means to achieve those needs. Fair enough, but in this conditioning, people fail to look at the positives. I strongly believe that there is enormous goodwill in this world and my thinking is reinforced by Abundance. Abundance is basically very positive, we believe there is enough in the world for people to share. So, to me, Abundance is hope in a situation where people do not see that hope. I do recognize that this is difficult, because the material needs are so intense and the means to address these needs are scarce, I mean you can’t teach philosophy to someone that is struggling to feed from hand to mouth. Looking at Mbando village for instance, Abundance creates a space for people to take a step back, reflect and separate. Abundance for me is about the collective hope, for one person there might be no hope, but if people come together there is collective hope.
Deepa: I like how you articulated that, so we have lots of projects, ideas, policies on poverty reduction. On the one hand, we have this whole world which runs on money, every year about $50 billion dollars is pumped as aid towards tackling poverty in Africa but poverty in some forms and aspects seems to be increasing. How do you see the role of money in poverty reduction?
MeghRaj: Well, there is an economic definition of poverty, a philosophical definition of poverty and an individual’s perception of what poverty is. So, it can be economic poverty, material poverty etc.. I don’t see poverty as just one word it cannot just be defined in one dimension it is multicultural and multi-dimensional. Because of the lack of a holistic view of poverty people tend to react to poverty based on what they feel is the most convenient thing to do. Also keep in mind that what is also very visible is the immediate consequences of economic poverty, so people think that the way to address poverty is to address these consequences. But that’s actually not what we should be addressing, the cause of poverty is not having the money, no, the cause of poverty is actually not having the systems that ensure that people have access. So, for me basically when people are pumping money and expecting it to alleviate poverty then I think they are on the wrong track because there are so many factors not being put into consideration.
If you look at the whole ecosystem in which a human being thrives although money is important it is not the most important thing, it is important to have mechanisms in place that enable people better cope with poverty. But what happens in the cycle of poverty is that once people are languishing, in poverty- forgive my choice of words- the likelihood of them coming out of it is very minimal due to the fact that people are obsessed with addressing the material needs without really looking at the potentials. So the financial impulse as a poverty reduction strategy, in my opinion, failed because it did not look at the systems responsible for the creation of poverty in the first place. I think that’s a problem, in my opinion, the way the world chose to address poverty, is very symbolic and symptomatic. In the problem analysis, we thus fail to look at the casual pathway as to why poverty is and how they define poverty.
Deepa: Talking about development, we have several models. We also have NGOs, Governments and other people working in development. Some people argue that development is happening wrongly and perhaps development isn’t the path we should take. What is your opinion on this?
MeghRaj: Again, we conventionally pitch ourselves to define development from a narrow perspective. I do recognise the reasons, and that we are looking at development again from the economic perspective; livelihood and comfort of the people. For example, access to certain services and that has become the definition of development and we quickly look at indicators to achieve this economic targets. But that’s not ideally development if we continue on that path we would never have holistic development. If, we define development as the whole ecosystem in which a human person thrives and the nodal point is the human being himself then for development to happen within that ecosystem and for his own development he would have to be the change agent, not the external input.
Deepa: Does that mean the transformation would come from within?
MeghRaj: Exactly, from within the people, people-centred development and the transformation would have to come from the self-realization, not even awareness. People, Deepa are aware but not necessarily educated. The most critical thing for me is the emotional intelligence; resilience and your understanding of the world comes from that, your understanding of a certain predicament and how you address this comes from your emotional intelligence, then you choose a well-informed strategy to address your development needs, I ’m not saying right or wrong. Strategies are not necessarily taking to the streets, that address the intrinsic, extrinsic needs and weaknesses. Again, as long as we tie our matric for measuring development to material lack of abundance, we wouldn’t be able to make the individual a development centred person.
I wanted to mention this earlier, while I was addressing what ‘Abundance’ means to me it’s more than just a generic term, for me the human capital we are building in Mbando village is ‘Abundance’. Moses is my hero, Ruth is my hero, the young kids we saw two days ago who remembered me from a few months ago. The potential in them- that’s abundance. For me we are building tremendous human capital in that community- that is abundance!
Deepa: What’s your take on global health challenge with regards to the access initiative. How is it different from what is globally available?
MeghRaj: To begin with there isn’t a globally agreed definition of global health as there are so many schools of thought informed by their perception of what will or not work in primary health. But what is common is that they all look at the public and primary health care and are conscious of the gap in those systems. Alma Ata Declaration was exactly 40years today and that declaration is among the noblest document produced with regards to global health. At the time the world was just coming out from socialism and the socialized healthcare until then was what made the healthcare sustained after the World War. So in the declaration, everyone made a commitment to universal health care as the agenda and what it means is that every human must have access to not just basic but quality health care irrespective of that person’s ability to pay for the treatment. What it implies is that people should not sell household assets to buy treatment. My argument is when we look at the whole welfare indicators for Africa for example, there are several ways people measure poverty in Africa some of these do not lay emphasis on other assets like livestock for instance. And I have seen people selling chicken to buy malaria treatment and that shouldn’t be the case. If the state allows that to happen even within the socialised healthcare model then actually you are pushing people into poverty!
So what happens is that there is a health facility run by the government and the government pays health workers so that individuals can go there to take treatment but there is no medication there and the person is compelled to go somewhere else to get the medication and this comes at a cost of depletion of other household assets. Primary healthcare failed because the way it was approached did not really achieve universal access. And then public healthcare took a very disease-centric approach without adequately looking at the casual pathways so was totally epidemic, one epidemic after another without looking at the systems. For example, the impact of Ebola in West Africa is much more pronounced today and I attribute that to the fragile health systems, they were already struggling to manage tuberculosis and HIV epidemic. So, we are not looking at health systems basically and health systems in a holistic view of the policy environment, fiscal commitment, legal frameworks and capacity, the whole six building blocks of the WHO. So we thought there is a great opportunity for us not only to positively challenge but educate the policy and governance on why global health is an important evolving science and we define it as “an evolution of primary health and public health into global healthcare”.
Public healthcare had not earlier factored into consideration people on the move and global health security; transborder workers. Take for example, the over half a million Basotho mine workers in the informal sector in South Africa, though on paper nothing discriminates against them, they cannot access health care in South Africa because the framework doesn’t provide for that, so that’s a global health security risk. So global health looks at issues like that, that’s the reason why a few of my friends and I came together to establish the Global Health Access Initiative (GHAI) which basically looks at these and tries to address the causal pathways in a much more systematic manner. We developed a three-pillar approach which involves talking to the government in a way they understand to prioritise global health, also trying to bridge the disconnect that exists between Universities that teach global health and the community thus making the academia more aware and sensitive about what works and what is needed and finally we look at what contributed to these gaps in universal health care that had to do with the healthcare providers.
Deepa: Moving on to another area- What does sustainability mean to you?
MeghRaj: For me, sustainability is your approach to ensure that the impact of implemented activities is sustained. Sustainability is not the injection of funds, personally, I feel it's about sustaining people’s behaviour, their attitudes by doing so we are able to sustain the impact of what we are doing.
Deepa: How do you feel about your journey with Abundance?
MeghRaj: I have seen so many organisations coming and going, there are so many organisations started by the people that have genuine concerns about what is happening in the world. For me, my journey with abundance helps me stay in touch with reality, for example, it keeps that community Mbando in my vision and it also reiterates my philosophy that what it takes is one individual, one idea, one thought to change the fate of billions of individuals!