„Health as a Human Right – Concepts of Health and Access to Healthcare”

After a long time, I participated in a STUBE seminar again. This time, the STUBE weekend seminar took place in Helmstedt. It started on Friday, 21 June 2024, and ended on Sunday, 23 June 2024. After all participants had arrived at the conference center, St. Ludgerus Monastery, we had time to unpack and relax until dinner. We then began our weekend seminar with an introduction, ice-breaking games, guidelines, expectations, and an overview of the tasks for the following day. To understand what is important for health from both internal and external influences, we were divided into groups of five and assigned topics related to health. The first group focused on armed conflict and public health, the second on knowledge decolonization, the third on climate change and health, and the last group on the migrant crisis and access to health. The seminar organizers provided texts to prepare us on the topics and ensure we had a common understanding.

Saturday morning started with Lilit Poghasyan’s presentation on “Global Health Challenges and Efforts to Improve Health”. She is a Master’s student in Political Science and currently interning at KED / STUBE Niedersachsen. In her presentation, we learned about the role of Fairtrade International as an organisation working in the Fair Trade area, and the importance of Fair Trade in improving health. We discussed the relationship between Fair Trade standards and certifications, working conditions related to the International Labour Organization (ILO), and the benefits of the Fair Trade premium, such as receiving additional money, training, and occupational safety and health (OSH) care. Lilit provided examples of how Fair Trade premiums have been used to build healthcare facilities, buy blankets, and establish schools in African countries. This encouraged us to support Fair Trade products, which contribute to ecological, economical, and social sustainability in other parts of the world. We also learned that progress in Fair Trade certification doesn’t happen magically but starts from the basics and gradually leads to premium certification, highlighting the importance of progress.

Before lunch, there was a workshop by Miriam Riechers, the head of division for project management at Deutsche Stiftung Weltbevölkerung (DSW, the German Foundation for World Population), Hannover, on the topic of “From Policy to Practice: Ensuring Sexual and Reproductive Health and Rights (SRHR)”. Here, we received basic information about SRHR and global perspectives on the topic. We learned about the challenges faced by some developing countries or regions and how to manage projects through group work on case studies. Miriam presented topics such as future prospects for young people from East Africa going to Berlin to give a speech, sexuality education and contraception, equal rights for people, and the power of political dialogue.

To engage youth in caring about SRHR, DSW found that the best approach so far is through peer education, mobile nurses to remote areas or clinics, youth trucks, youth campaigns, improving social environments, and training centers. This innovative and sustainable project is effective because peer education takes place in youth clubs, where young people meet in or out of school to discuss SRHR. This leads to youth empowerment, creating networks and income-generating systems, such as producing reusable pads, comics, and newspapers about SRHR. To sharpen our youth and project management skills, the case studies required us to develop project proposals in small groups on topics like LGBTQ+ rights in conservative areas, access to contraceptives in rural areas, and high maternal mortality in urban slums. I found the last case particularly interesting because it was presented by a group of men. They mentioned that they had to learn many new concepts and definitions to develop the project proposal for this case.

Afterward, we continued the political science seminar with a session on “Activist Struggles for Health Justice” by Felix Litschauer, a global health advocate at medico international e.V., Frankfurt. He began with the history and mission of medico international, which has been promoting the human right to health for 50 years. They do this by providing medical units and supplies, and medical drugs for countries facing natural disasters, then shifting to addressing political and social problems, root causes of diseases, supporting movements, and campaigning on global issues. When the World Health Organization (WHO) adopted the primary health care approach in 1978, movements like the People’s Health Movement (phmovement.org) emerged, providing a platform for activists in every country to advocate for better health.

We learned to identify the root causes of diseases, the contributing factors, and the outcomes. For example, in the case of malnutrition in small children, it is crucial to address the root causes rather than just treating the symptoms, ensuring that the health improvements are sustainable. We also discussed how diseases often stem from behavior, knowledge about first aid, environmental factors, and local or national policies. This clearly showed the connection between health and social life. For instance, in Chicago, a poor person has a life expectancy of 60 years, while in a wealthier area, life expectancy can increase to 90 years. Felix concluded that poverty directly affects life expectancy.

He then asked us to consider the social determinants of health, such as education, nutrition, and housing. However, there are many others, including water and sanitation, environmental climate, working conditions, accidents, violence, discrimination, lack of social integration, and psychosocial stress. The goal of health equity is to provide healthcare that addresses these social determinants. Using the river analogy, Felix explained that downstream represents medical care, the middle of the river represents preventive measures like education, and upstream represents policies that make the riverbank safe, preventing people from falling into the river in the first place. Health is a human right, and it is the government’s responsibility to provide healthcare for its citizens.

Felix concluded his session with group work from three different country perspectives: Germany, South Africa, and Lebanon. We were given real cases along with scientific papers to help us sharpen our skills in reading, summarizing scientific articles, and identifying root causes, a concept we had just learned in his session. In the end, we discussed how we can contribute to health justice.

Our day continued with an outdoor activity. Thankfully, the weather was nice, and our city tour went smoothly. We started with the oldest church in town, which was within our accommodation. We then visited the former university and the professors’ houses. We continued walking to the town hall and an old watchtower with a town gate. It was interesting to hear the historical story about the guard, whose job was to open the town gate every day. We also visited the oldest house in town, which is now used as a civil registration office.

The day ended with the presentation of the group work from the case studies we were given at the beginning of the seminar. The presentations were well-done, and our understanding of human health and human rights deepened thanks to the day’s input.

On the last day, we gained insights into “Global Health in Parliament” from Ottmar von Holtz, a member of the Bundestag (the German Federal Parliament in Berlin) from Hildesheim. We learned that the German parliament is actively working on and planning initiatives related to global health. We also learned about the structure of the parliament, its committees, and subcommittees.

Mr. von Holtz explained German politics in a simple and engaging way, making it accessible even to international students who do not study politics. This knowledge is crucial for all members of society, including international students like us, who plan to live in Germany long-term, as it helps us understand how the Bundestag operates. We also learned about the subcommittees that provide advice and maintain connections with stakeholders. In this context, experts focus on areas such as women’s health, climate change, water management, deadly diseases, pandemic vaccines, and funding for global health. The German parliament also collaborates with key multilateral organizations such as the WHO (World Health Organization), a UN agency responsible for international public health, and the GFATM (Global Fund to Fight AIDS, Tuberculosis and Malaria), which finances programs to combat these diseases in low- and middle-income countries. Additionally, the parliament works with prominent German organizations like “Brot für die Welt”, a development organization fighting hunger and poverty worldwide; Deutsche Stiftung Weltbevölkerung (DSW), which focuses on sexual and reproductive health and rights, particularly in developing countries; and medico international, an NGO that supports global health and human rights projects, addressing the root causes of poverty and promoting the right to health.

We learned how to strengthen health systems and how the world works from a political perspective, including how money is allocated and spent, which involves global associations and interesting organizations. The role of parliamentarians in subcommittees is to manage funding, reduce dependency, and set agendas. According to Mr. von Holtz, having strong healthcare systems requires a dedicated ministry, organizational structures, specialists, and the ability to provide guidance. Health should be independent, meaning people should have the power to decide about their own futures, not just be treated for illnesses. We all have a responsibility to care for and develop global health, which includes ensuring access to clean water, proper nutrition, and self-determination to achieve these goals together.

See you in another STUBE seminar.

Lisa Wirjantoro

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